Sequential transurethral surgery, multiple drug chemotherapy and radiation therapy for invasive bladder carcinoma: Initial report
- Inst. of Oncology, Ljubljana (Slovenia)
- 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), Vol. 25:5; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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LEUKOPENIA
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PLATINUM
POST-IRRADIATION EXAMINATION
SIDE EFFECTS
SURGERY
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AZAARENES
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DRUGS
ELEMENTS
HEMIC DISEASES
HETEROCYCLIC COMPOUNDS
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NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PLATINUM METALS
PYRROLES
RADIOLOGY
SYMPTOMS
THERAPY
TRANSITION ELEMENTS
URINARY TRACT
550603* - Medicine- External Radiation in Therapy- (1980-)