Chemotherapy Plus Radiotherapy May Enable Bladder Preservation
Combining cisplatin-based intra-arterial chemotherapy and radiotherapy is effective long-term for local invasive bladder carcinoma, according to a Japanese study.
The study included 24 patients (18 men and six women) with a median age of 73 years (range 31-85 years). All patients received cisplatin-based intra-arterial chemotherapy and radiotherapy for invasive bladder carcinoma. The median follow-up period was 60 months. The subjects underwent biopsy to confirm the pathologic diagnosis.
The five-year overall survival rate and cancer-specific survival rate for the study population were 81.6% and 85.6%, respectively, the researchers reported in the International Journal of Urology. (2007; published online ahead of print).
Ten patients had a complete response (CR) and 14 had a non-complete response (non-CR). The five-year overall survival rate for the CR and non-CR groups was 87.5% and 78.6%, a nonsignificant difference between groups. This finding suggests the possibility of bladder preservation with periodic examinations in CR patients, the authors noted.
Tumor grade was significantly lower in the CR group than in the non-CR group. When the non-CR group was divided into those who underwent radical cystectomy and those who did not, the five-year overall survival rate was 100% for the radical cystectomy group and 70% for the patients who did not have radical surgery, but the difference was not statistically significant.
The investigators noted that a limitation of the study was the small study population. The lack of significant difference in five-year survival in the CR and non-CR groups might have been due to the small number of subjects.