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Title: Proton beam therapy for invasive bladder cancer: A prospective study of bladder-preserving therapy with combined radiotherapy and intra-arterial chemotherapy

Abstract

Purpose: To present outcomes of bladder-preserving therapy with proton beam irradiation in patients with invasive bladder cancer. Methods and Materials: Twenty-five patients with transitional cell carcinoma of the urinary bladder, cT2-3N0M0, underwent transurethral resection of bladder tumor(s), followed by pelvic X-ray irradiation combined with intra-arterial chemotherapy with methotrexate and cisplatin. Upon completion of these treatments, patients were evaluated by transurethral resection biopsy. Patients with no residual tumor received proton irradiation boost to the primary sites, whereas patients demonstrating residual tumors underwent radical cystectomy. Results: Of 25 patients, 23 (92%) were free of residual tumor at the time of re-evaluation; consequently, proton beam therapy was applied. The remaining 2 patients presenting with residual tumors underwent radical cystectomy. Of the 23 patients treated with proton beam therapy, 9 experienced recurrence at the median follow-up time of 4.8 years: local recurrences and distant metastases in 6 and 2 patients, respectively, and both situations in 1. The 5-year overall, disease-free, and cause-specific survival rates were 60%, 50%, and 80%, respectively. The 5-year local control and bladder-preservation rates were 73% and 96%, respectively, in the patients treated with proton beam therapy. Therapy-related toxicities of Grade 3-4 were observed in 9 patients: hematologic toxicities in 6,more » pulmonary thrombosis in 1, and hemorrhagic cystitis in 2. Conclusions: The present bladder-preserving regimen for invasive bladder cancer was feasible and effective. Proton beam therapy might improve local control and facilitate bladder preservation.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [6];  [3];  [4];  [3];  [4];  [3];  [4];  [2];  [2];  [2];  [3];  [4]
  1. Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan) and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan). E-mail: mhata@syd.odn.ne.jp
  2. Department of Urology, University of Tsukuba, Tsukuba, Ibaraki (Japan)
  3. Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan)
  4. (Japan)
  5. Department of Radiology, University of Tsukuba, Tsukuba, Ibaraki (Japan)
  6. Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan)
Publication Date:
OSTI Identifier:
20793421
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2005.10.023; PII: S0360-3016(05)02942-1; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; BLADDER; CARCINOMAS; CHEMOTHERAPY; EVALUATION; IRRADIATION; METASTASES; METHOTREXATE; PATIENTS; PRESERVATION; PROTON BEAMS; RADIOTHERAPY; THROMBOSIS; TOXICITY; X RADIATION

Citation Formats

Hata, Masaharu, Miyanaga, Naoto, Tokuuye, Koichi, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Saida, Yukihisa, Ohara, Kiyoshi, Sugahara, Shinji, Kagei, Kenji, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Igaki, Hiroshi, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Hashimoto, Takayuki, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Hattori, Kazunori, Shimazui, Toru, Akaza, Hideyuki, Akine, Yasuyuki, and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki. Proton beam therapy for invasive bladder cancer: A prospective study of bladder-preserving therapy with combined radiotherapy and intra-arterial chemotherapy. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.1.
Hata, Masaharu, Miyanaga, Naoto, Tokuuye, Koichi, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Saida, Yukihisa, Ohara, Kiyoshi, Sugahara, Shinji, Kagei, Kenji, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Igaki, Hiroshi, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Hashimoto, Takayuki, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Hattori, Kazunori, Shimazui, Toru, Akaza, Hideyuki, Akine, Yasuyuki, & Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki. Proton beam therapy for invasive bladder cancer: A prospective study of bladder-preserving therapy with combined radiotherapy and intra-arterial chemotherapy. United States. doi:10.1016/J.IJROBP.2005.1.
Hata, Masaharu, Miyanaga, Naoto, Tokuuye, Koichi, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Saida, Yukihisa, Ohara, Kiyoshi, Sugahara, Shinji, Kagei, Kenji, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Igaki, Hiroshi, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Hashimoto, Takayuki, Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Hattori, Kazunori, Shimazui, Toru, Akaza, Hideyuki, Akine, Yasuyuki, and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki. Sat . "Proton beam therapy for invasive bladder cancer: A prospective study of bladder-preserving therapy with combined radiotherapy and intra-arterial chemotherapy". United States. doi:10.1016/J.IJROBP.2005.1.
@article{osti_20793421,
title = {Proton beam therapy for invasive bladder cancer: A prospective study of bladder-preserving therapy with combined radiotherapy and intra-arterial chemotherapy},
author = {Hata, Masaharu and Miyanaga, Naoto and Tokuuye, Koichi and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki and Saida, Yukihisa and Ohara, Kiyoshi and Sugahara, Shinji and Kagei, Kenji and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki and Igaki, Hiroshi and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki and Hashimoto, Takayuki and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki and Hattori, Kazunori and Shimazui, Toru and Akaza, Hideyuki and Akine, Yasuyuki and Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki},
abstractNote = {Purpose: To present outcomes of bladder-preserving therapy with proton beam irradiation in patients with invasive bladder cancer. Methods and Materials: Twenty-five patients with transitional cell carcinoma of the urinary bladder, cT2-3N0M0, underwent transurethral resection of bladder tumor(s), followed by pelvic X-ray irradiation combined with intra-arterial chemotherapy with methotrexate and cisplatin. Upon completion of these treatments, patients were evaluated by transurethral resection biopsy. Patients with no residual tumor received proton irradiation boost to the primary sites, whereas patients demonstrating residual tumors underwent radical cystectomy. Results: Of 25 patients, 23 (92%) were free of residual tumor at the time of re-evaluation; consequently, proton beam therapy was applied. The remaining 2 patients presenting with residual tumors underwent radical cystectomy. Of the 23 patients treated with proton beam therapy, 9 experienced recurrence at the median follow-up time of 4.8 years: local recurrences and distant metastases in 6 and 2 patients, respectively, and both situations in 1. The 5-year overall, disease-free, and cause-specific survival rates were 60%, 50%, and 80%, respectively. The 5-year local control and bladder-preservation rates were 73% and 96%, respectively, in the patients treated with proton beam therapy. Therapy-related toxicities of Grade 3-4 were observed in 9 patients: hematologic toxicities in 6, pulmonary thrombosis in 1, and hemorrhagic cystitis in 2. Conclusions: The present bladder-preserving regimen for invasive bladder cancer was feasible and effective. Proton beam therapy might improve local control and facilitate bladder preservation.},
doi = {10.1016/J.IJROBP.2005.1},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 64,
place = {United States},
year = {Sat Apr 01 00:00:00 EST 2006},
month = {Sat Apr 01 00:00:00 EST 2006}
}