Combined modality program with possible organ preservation for invasive bladder carcinoma: Results of RTOG protocol 85-12

Journal Article · Fri Apr 02 04:00:00 EST 1993 · International Journal of Radiation Oncology, Biology and Physics; (United States)

DOI:https://doi.org/10.1016/0360-3016(93)90306-G· OSTI ID:6523535

Tester, W; Porter, A; Asbell, S; Coughlin, C; Heaney, J; Krall, J; Martz, K; Venner, P; Hammond, E ^[1]

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1. Radiation Therapy Oncology Group, Philadelphia, PA (United States)

This Phase 2 study was designed to test the tolerance and effectiveness of concurrent cisplatin-radiotherapy in the treatment of invasive bladder cancer. Objectives were to determine toxicity, complete response rate, bladder preservation rate, and survival. Patients with invasive bladder cancer, clinical Stages T2--4, NO-2 or NX, MO were treated with pelvic radiotherapy 40 Gy in 4 weeks and cisplatin 100 mg/m[sup 2] on days 1 and 22. Complete responders were given an additional 24 Gy bladder boost plus a third dose of cisplatin; patients with residual tumor after 40 Gy were assigned radical cystectomy. The complete remission rate following cisplatin and 40 Gy for evaluable cases was 31/47 (66%). Acute toxicity was acceptable with only two patients not completing induction therapy. Patients with poorly differentiated tumors were more likely to achieve complete remission. Of fully evaluable patients, 28/42 (67%) achieved complete remission with induction therapy, 11 remain continuously in remission, and eight have relapsed with bladder as the only site of failure. Five of these eight cases relapsed with noninvasive tumor. Of the 14 patients who failed to achieve complete remission, only three remain disease-free. Median survival is not reached, with 17/42 (19/48) deaths reported. Actuarial survival is 64% at 3 years. This combined cisplatin-radiotherapy regime was moderately well-tolerated and associated with tumor clearance in 66% of patients treated. Isolated bladder recurrences with invasive carcinoma are infrequent. Better definition of pretreatment selection criteria is needed if combined modality treatment is to achieve disease control and organ preservation for patients with bladder cancer. 37 refs., 3 figs., 5 tabs.

• OSTI ID: 6523535
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (United States), Journal Name: International Journal of Radiation Oncology, Biology and Physics; (United States) Vol. 25:5; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BLADDER
BODY
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
DISEASES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PLATINUM COMPOUNDS
POST-IRRADIATION EXAMINATION
RADIOLOGY
RADIOTHERAPY
THERAPY
TRANSITION ELEMENT COMPOUNDS
URINARY TRACT