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Alternating chemo-radiotherapy in bladder cancer: a conservative approach
M Orsatti1, A Curotto, L Canobbio
1Istituto Nazionale per la Ricerca sul Cancro, Genova.
International Journal of Radiation Oncology, Biology, Physics
|August 30, 1995
Summary
This study explored bladder-sparing chemo-radiotherapy for invasive bladder cancer. The treatment showed high response rates and survival comparable to surgery, with manageable side effects.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Oncology
Background:
- Invasive bladder cancer necessitates aggressive treatment, often radical cystectomy, which impacts quality of life.
- Developing bladder-sparing alternatives is crucial for improving patient outcomes and quality of life.
Purpose of the Study:
- To evaluate the toxicity and survival outcomes of an alternated chemoradiotherapy regimen for invasive bladder cancer.
- To determine the efficacy of a bladder-sparing approach in patients with Stage T1G3-T4 N0 M0 bladder cancer.
Main Methods:
- Phase II clinical trial involving 76 patients with invasive bladder cancer.
- Patients received a combination chemotherapy regimen (Cisplatin and 5-Fluorouracil or Methotrexate) alternated with radiotherapy.
- Two different radiotherapy fractionation schedules were employed across patient groups.
Main Results:
- Achieved a clinical complete response in 81% of patients and partial response in 10%.
- At a median follow-up of 45 months, 47% of patients were alive and tumor-free.
- 6-year overall and progression-free survival rates were 42% and 40%, respectively, with mild systemic and moderate/severe local toxicity in approximately 20% of patients.
Conclusions:
- Conservative bladder-sparing chemoradiotherapy is effective for invasive bladder cancer.
- This approach offers survival rates comparable to radical cystectomy while preserving bladder function.