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Combined chemoradiotherapy for invasive bladder cancer: a feasibility approach in a non selected population
C de Pree1, M S Aapro, B Mermillod
1Département de Medecine, University Hospital, Geneva, Switzerland.
Background:
We aimed to evaluate the tolerance and response rate to neo-adjuvant combined chemo-radiotherapy and to determine the possibilities of conservative treatment in patients (pts) with muscle invasive bladder cancer.
Methods:
Thirty-nine T1-4, NO-3 pts were enrolled in this study. After 2 cycles of treatment, responders at intermediate assessment were treated by either additional chemotherapy +/- radiotherapy or radical cystectomy. If there was evidence of persistent tumour, radical cystectomy was performed whenever possible.
Results:
Thirty-five (90%) pts completed the pre-operative treatment, 26/39 (67%) were in remission at intermediate assessment and 8 of them underwent a radical cystectomy. The median follow-up was 87 months, and 15 pts are alive without evidence of tumour and 5 with bladder preservation. The 3 and 5-year survival was 51 and 40%, respectively. Median survival differences between the responding operated or non-operated pts were not statistically different.
Conclusions:
Neo-adjuvant chemo-radiotherapy for invasive bladder cancer is effective with acceptable toxicity, and inoperable patients can benefit from such treatment.