Bladder preservation by chemoradiotherapy in combination with radical tur-bt in muscle invasive bladder cancer

Abstract

(Purpose) To evaluate bladder preservation protocol by radical TUR-Bt and subsequent concurrent chemoradiotherapy in muscle invasive bladder cancer. (Patients and methods) Twenty-six patients with muscle invasive bladder cancer (T2-T4N0M0) were treated with concurrent chemoradiotherapy after transurethral resection of the tumor as much as possible beyond muscle layers. Chemotherapy was consisted of systemic administration of methoterexete (30 mg/m2 day1 and day 22) and intraarterial infusion of cisplatin (70 mg/m2, day2 and day 23). The response was evaluated by TUR, urine cytology, CT and/or MRI4 to 6 weeks after the treatment. (Results) Among 24 evaluable cases, pathological complete response was achieved in 13 cases (50%) and residual tumors were noted in 11 cases (pT1 in 9 and pT2 in 2). During follow-up period up to 69.8 months, Invasive recurrence was observed in 2 cases, superficial recurrence was noted in 5 patients and distant metastasis without evidence of local recurrence was noted in 4 cases. Overall bladder preservation rate was 92%. (Conclusions) The bladder preservation by radical TUR-Bt and chmeradiotherapy is a safe and effective treatment option for muscle invasive bladder cancer.