[Systemic chemotherapy in advanced bladder cancer. New aspects]

Systemic chemotherapy has gained increasing importance in the treatment of advanced bladder cancer over the past few years. Implementation of cisplatin- and methotrexate-containing chemotherapy regimens results in a complete remission rate of over 20% in patients with metastatic bladder cancer. In view of these results prolongation of tumour-free survival is possible. A further indication for systemic chemotherapy is in cases of locally-advanced bladder cancer; in these patients chemotherapy can be given alone or in combination with irradiation. T3-tumours can be destroyed by integrated radiotherapy and chemotherapy in more than 70% of cases. The influence of this treatment modality on micrometastases is unclear.