Limits...
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

Cause-specific survival rates (CSS) of complete response (CR) at the first evaluation, CR at the second evaluation and the non-CR. Five-year CSS of these three groups were 100% (n=21), 85.9% (n=9) and 0% (n=7), respectively. Five-year CSS of CR groups were significantly higher than that of non-CR group (P<0.0001, P=0.0163, respectively)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4300573&req=5

Figure 3: Cause-specific survival rates (CSS) of complete response (CR) at the first evaluation, CR at the second evaluation and the non-CR. Five-year CSS of these three groups were 100% (n=21), 85.9% (n=9) and 0% (n=7), respectively. Five-year CSS of CR groups were significantly higher than that of non-CR group (P<0.0001, P=0.0163, respectively)

Mentions: Of the 16 patients who did not achieve CR at the first evaluation, 14 underwent additional IACT with CDDP and THP/DXR, and 2 received no additional treatment due to poor general condition. After completing additional IACT, 9 of 14 patients achieved CR at the second evaluation. Among these patients, 4 developed local recurrences in the bladder (3 non-invasive and 1 invasive tumors), and 2 had distant metastases. Six were alive at the latest follow-up (5 without disease and 1 with distant metastasis) and 3 died (2 of bladder cancer and 1 of other cause). Of the 7 non-CR patients, 1 was alive with distant metastasis and 6 died (3 of bladder cancer and 3 of other causes). The 5-year cause specific survivals of the CR group at the first evaluation, the CR group at the second evaluation and the non-CR group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively [Figure 3]. The 5-year cause specific survivals of the CR groups were significantly higher than that of the non-CR group (P < 0.0001, P = 0.0163, respectively). The 5-year overall survivals of the CR group at the first evaluation, the CR group at the second evaluation and the non-CR group were 82.8%, 85.3% and 0%, respectively [Figure 4]. The 5-year overall survivals of the CR groups were significantly higher than that of the non-CR group (P < 0.0001, P = 0.0014, respectively).


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)

Cause-specific survival rates (CSS) of complete response (CR) at the first evaluation, CR at the second evaluation and the non-CR. Five-year CSS of these three groups were 100% (n=21), 85.9% (n=9) and 0% (n=7), respectively. Five-year CSS of CR groups were significantly higher than that of non-CR group (P<0.0001, P=0.0163, respectively)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Cause-specific survival rates (CSS) of complete response (CR) at the first evaluation, CR at the second evaluation and the non-CR. Five-year CSS of these three groups were 100% (n=21), 85.9% (n=9) and 0% (n=7), respectively. Five-year CSS of CR groups were significantly higher than that of non-CR group (P<0.0001, P=0.0163, respectively)
Mentions: Of the 16 patients who did not achieve CR at the first evaluation, 14 underwent additional IACT with CDDP and THP/DXR, and 2 received no additional treatment due to poor general condition. After completing additional IACT, 9 of 14 patients achieved CR at the second evaluation. Among these patients, 4 developed local recurrences in the bladder (3 non-invasive and 1 invasive tumors), and 2 had distant metastases. Six were alive at the latest follow-up (5 without disease and 1 with distant metastasis) and 3 died (2 of bladder cancer and 1 of other cause). Of the 7 non-CR patients, 1 was alive with distant metastasis and 6 died (3 of bladder cancer and 3 of other causes). The 5-year cause specific survivals of the CR group at the first evaluation, the CR group at the second evaluation and the non-CR group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively [Figure 3]. The 5-year cause specific survivals of the CR groups were significantly higher than that of the non-CR group (P < 0.0001, P = 0.0163, respectively). The 5-year overall survivals of the CR group at the first evaluation, the CR group at the second evaluation and the non-CR group were 82.8%, 85.3% and 0%, respectively [Figure 4]. The 5-year overall survivals of the CR groups were significantly higher than that of the non-CR group (P < 0.0001, P = 0.0014, respectively).

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