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Superiority of Adjuvant Hyperfractionated Radiotherapy Over Chemotherapy Following Radical Cystectomy
Asmaa Salah Ibrahim1, Doaa Ali Gamal2, Abdallah Hadia3
1Radiotherapy Department at South Egypt Cancer Institute, Assiut University, Egypt.
Asian Pacific Journal of Cancer Prevention : APJCP
|July 29, 2026
Summary
Adjuvant chemotherapy plus radiotherapy significantly improved survival outcomes for bladder cancer patients after radical cystectomy. This combined approach reduced local recurrence and prolonged overall survival compared to chemotherapy alone.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Oncology
Background:
- Bladder cancer recurrence after radical cystectomy is common despite chemotherapy.
- Adjuvant treatments are crucial for improving outcomes in localized bladder cancer (LABC).
Purpose of the Study:
- To compare the efficacy of adjuvant sandwich chemotherapy plus radiotherapy versus chemotherapy alone for LABC post-radical cystectomy.
Main Methods:
- A phase III trial randomized 125 patients undergoing radical cystectomy.
- Treatment arms: 1) Gemcitabine/cisplatin cycles before and after radiotherapy (RT), 2) Gemcitabine/cisplatin chemotherapy alone.
Main Results:
- The combined chemotherapy plus RT group showed significantly reduced local recurrence (LRF).
- Overall survival (OS) was significantly improved in the combined group (64.9% alive) versus chemotherapy alone (5.9%).
- Time to distant metastasis (DM) was significantly prolonged with combined therapy.
Conclusions:
- Adjuvant chemotherapy combined with radiotherapy significantly enhances local recurrence-free survival (LRFS) in LABC.
- This combined approach leads to improved overall survival (OS) compared to chemotherapy alone.
