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External beam radiation plus concurrent intra-arterial chemotherapy with low dose cisplatin for muscle invasive bladder cancer.

Matsumoto Y, Samma S, Fukui S, Nakai Y, Kagebayashi Y, Torimoto K - Indian J Urol (2015 Jan-Mar)

Bottom Line: Five-year cause specific survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively.Five-year overall survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 82.8%, 85.3% and 0%, respectively.This trimodality therapy can be one of the useful treatment options.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Nara Prefectural Nara Hospital, Nara, Japan.

ABSTRACT

Introduction: We aimed to investigate the long-term outcome of trimodality therapy consisting of transurethral resection of bladder tumor, external beam radiation therapy, and concurrent intra-arterial low dose cisplatin for patients with muscle invasive bladder cancer.

Materials and methods: We retrospectively reviewed the medical records of 37 consecutive patients (28 men and 9 women) who underwent trimodality therapy for T2-3N0M0 bladder cancer at our hospital between 1996 and 2011. A total of 60Gy of external beam radiation therapy was administered. A daily low dose of cisplatin was administered intra-arterially through a subcutaneously placed reservoir on the days of radiation therapy. Complete response was defined as no residual cancer in transurethral resection specimens and negative cytology. When a complete response could not be achieved, patients underwent additional intra-arterial chemotherapy.

Results: Five-year cause specific, disease free, and overall survival rates were 86.4%, 69.7%, and 69.6%, respectively, with a mean follow-up period of 56.5 ± 6.1 months. Five-year cause specific survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively. Five-year overall survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 82.8%, 85.3% and 0%, respectively.

Conclusions: This trimodality therapy for muscle invasive bladder cancer could achieve favorable survival rates with bladder preservation and minimal adverse events. This trimodality therapy can be one of the useful treatment options.

No MeSH data available.


Related in: MedlinePlus

Treatment schedule
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Figure 1: Treatment schedule

Mentions: Our treatment schedule is shown in Figure 1. Initially, all patients underwent TUR-BT, in which all visible tumors including the muscle layer were resected as deep as possible to confirm the pathological tumor stage and reduce the volume of the tumor. Prior to chemoradiotherapy, a port (P-U CELSITE PORT®, TORAY, Japan) was placed in the femoral subcutaneous tissue and a catheter (ANTHRON P-U CATHETER®, TORAY, Japan) was placed in the internal iliac artery. Coil embolization of superior and inferior gluteal arteries and obturator arteries were performed to modify the blood flow. In 19 patients, ports and catheters were placed bilaterally in the right and left internal iliac arteries, and in the remaining 18 patients in either the right or left iliac artery, according to the location of the main tumor.


External beam radiation plus concurrent intra-arterial chemotherapy with low dose cisplatin for muscle invasive bladder cancer.

Matsumoto Y, Samma S, Fukui S, Nakai Y, Kagebayashi Y, Torimoto K - Indian J Urol (2015 Jan-Mar)

Treatment schedule
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300573&req=5

Figure 1: Treatment schedule
Mentions: Our treatment schedule is shown in Figure 1. Initially, all patients underwent TUR-BT, in which all visible tumors including the muscle layer were resected as deep as possible to confirm the pathological tumor stage and reduce the volume of the tumor. Prior to chemoradiotherapy, a port (P-U CELSITE PORT®, TORAY, Japan) was placed in the femoral subcutaneous tissue and a catheter (ANTHRON P-U CATHETER®, TORAY, Japan) was placed in the internal iliac artery. Coil embolization of superior and inferior gluteal arteries and obturator arteries were performed to modify the blood flow. In 19 patients, ports and catheters were placed bilaterally in the right and left internal iliac arteries, and in the remaining 18 patients in either the right or left iliac artery, according to the location of the main tumor.

Bottom Line: Five-year cause specific survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively.Five-year overall survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 82.8%, 85.3% and 0%, respectively.This trimodality therapy can be one of the useful treatment options.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Nara Prefectural Nara Hospital, Nara, Japan.

ABSTRACT

Introduction: We aimed to investigate the long-term outcome of trimodality therapy consisting of transurethral resection of bladder tumor, external beam radiation therapy, and concurrent intra-arterial low dose cisplatin for patients with muscle invasive bladder cancer.

Materials and methods: We retrospectively reviewed the medical records of 37 consecutive patients (28 men and 9 women) who underwent trimodality therapy for T2-3N0M0 bladder cancer at our hospital between 1996 and 2011. A total of 60Gy of external beam radiation therapy was administered. A daily low dose of cisplatin was administered intra-arterially through a subcutaneously placed reservoir on the days of radiation therapy. Complete response was defined as no residual cancer in transurethral resection specimens and negative cytology. When a complete response could not be achieved, patients underwent additional intra-arterial chemotherapy.

Results: Five-year cause specific, disease free, and overall survival rates were 86.4%, 69.7%, and 69.6%, respectively, with a mean follow-up period of 56.5 ± 6.1 months. Five-year cause specific survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively. Five-year overall survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 82.8%, 85.3% and 0%, respectively.

Conclusions: This trimodality therapy for muscle invasive bladder cancer could achieve favorable survival rates with bladder preservation and minimal adverse events. This trimodality therapy can be one of the useful treatment options.

No MeSH data available.


Related in: MedlinePlus