Sequential transurethral surgery, multiple drug chemotherapy and radiation therapy for invasive bladder carcinoma: Initial report

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)90305-F· OSTI ID:6523587

Cervek, J; Cufer, T; Kragelj, B; Zakotnik, B ^[1]; Stanonik, M ^[2]

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1. Inst. of Oncology, Ljubljana (Slovenia)
2. University Dept. of Urology, Ljubljana (Slovenia)

Forty-seven patients with muscle-invasive bladder cancer (T2--T4, Nx, MO) were treated by transurethral resection, followed by 3--4 cycles of combination chemotherapy (methothrexate 30 mg/m2 on days 1, 14; cis-platinum 100 mg/m2 on day 2; vinblastine 3 mg/m2 on days 1, 14; repeated every 21 days), and external beam irradiation (64--66 Gy to the bladder and 40 Gy to the pelvic lymphatics). Complete remission after transurethral resection and chemotherapy was achieved in 24 out of 45 patients (53%). Cystectomy was performed in patients without complete response to transurethral resection and chemotherapy. The therapy was completed as planned in 45/47 patients. After transurethral resection, chemotherapy, and radiation therapy, biopsy proven complete response was achieved in 62% (28/45); Stage T2T3 in 67% (23/24), Stage T4 in 45% (5/11) of patients. Among 19 patients with positive biopsy findings after transurethral resection and chemotherapy, 14 underwent cystectomy. After follow-up of 4--55 months (median 23 months) 75% (34/45) are alive, 68% (31/45) have had their bladders preserved, and 53% (24/45) are free of the primary tumor. The actuarial survival of all 45 patients is 73%. Moderate nausea and vomiting during treatment were common; severe leukopenia and mucositis were observed in five patients. Late side effects such as miction disorders and diarrhea were predominantly mild. Although the observation period has been too short to allow a definitive evaluation of treatment results, the authors feel both from the point of bladder preservation and disease-free survival that the presented treatment approach is successful in a majority of T2T3 patients, whereas a large tumor size (T4) renders this treatment less effective. 17 refs., 4 figs., 4 tabs.

• OSTI ID: 6523587
• 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
ALKALOIDS
ANTIMITOTIC DRUGS
AROMATICS
AZAARENES
AZOLES
BLADDER
BODY
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
DIARRHEA
DISEASES
DRUGS
ELEMENTS
HEMIC DISEASES
HETEROCYCLIC COMPOUNDS
IMMUNE SYSTEM DISEASES
INDOLES
LEUKOPENIA
MEDICINE
METALS
NAUSEA
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATIENTS
PLATINUM
PLATINUM METALS
POST-IRRADIATION EXAMINATION
PYRROLES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURGERY
SYMPTOMS
THERAPY
TRANSITION ELEMENTS
URINARY TRACT
VINBLASTINE
VOMITING