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Radiotherapy with and without cisplatin in bladder cancer
R Sauer1, J Dunst, A Altendorf-Hofmann
1Department of Radiation Therapy, University of Erlangen, Federal Republic of Germany.
International Journal of Radiation Oncology, Biology, Physics
|September 1, 1990
Summary
This study found that combining cisplatin chemotherapy with radiation therapy improved complete remission rates for invasive bladder cancer, especially after incomplete surgery. However, overall survival rates did not significantly change.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Oncology
Background:
- Invasive bladder carcinoma presents significant treatment challenges.
- Optimizing local control and survival in bladder cancer remains a critical area of research.
Purpose of the Study:
- To evaluate the efficacy of concurrent chemoradiation with cisplatin in patients with invasive bladder carcinoma.
- To assess the impact of transurethral resection (TUR) completeness on treatment outcomes.
Main Methods:
- A cohort of 67 patients with invasive bladder carcinoma (T1-4 N0-2 M0) received irradiation and concurrent cisplatin.
- Treatment involved 50.4 Gy irradiation over 6 weeks with cisplatin (25 mg/m2/day for 5 days) in weeks 1 and 5.
- Outcomes were analyzed based on tumor stage and completeness of prior transurethral resection (TUR).
Main Results:
- Complete remission rates varied by T-stage: T1 (8/11), T2 (14/16), T3 (27/36), and T4 (1/4).
- Complete remission rates were 67% (R0), 83% (R1), and 70% (R2) post-TUR.
- Patients with incomplete TUR (R1-2) showed a significantly higher complete remission rate (76%) compared to historical controls (45%, p<0.01).
- Estimated 3-year survival rates were T1: 73%, T2-3: 68%, T4: 25%. Overall 3-year survival was 66%, unchanged from historical controls.
Conclusions:
- Concurrent cisplatin and irradiation likely enhances local control rates, particularly following incomplete transurethral resection for bladder cancer.
- While local control may improve, significant enhancement of overall survival with this regimen appears unlikely.
- Severe complications were not observed, suggesting a favorable safety profile for this combined treatment approach.