[Radiotherapy and chemotherapy in infiltrating bladder tumors]

Bladder carcinoma needs multidisciplinary therapeutic approaches. Surgery classically is the main step of local treatment. Nevertheless, radiation therapy and chemotherapy are largely employed. Radiotherapy uses accelerator photon beams to treat pelvis and bladder up to a total dose of 65 Gy in 6 to 7 weeks. Local control rate after exclusive radiotherapy is 30-40% and morbidity is acceptable. Iridium-192 brachytherapy has limited indications and is generally performed after partial cystectomy. Chemotherapy is the treatment of metastatic bladder cancer. The more active drugs are cisplatin and methotrexate. They are combined polychemotherapy allowing a survival improvement in patients with metastatic disease. Concomitant radio-chemotherapy combinations appear as a promising strategy for conservative treatment.