Radiochemotherapy with cisplatin and 5-fluorouracil after transurethral surgery in patients with bladder cancer
| Autor: | Claus Rödel, Thomas Papadopoulos, Jürgen Dunst, Dirk G. Engehausen, Frens S. Krause, Christian Weiss, Rolf Sauer |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Urinary system medicine.medical_treatment law.invention Cystectomy Randomized controlled trial law Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Cisplatin Salvage Therapy Radiation Bladder cancer business.industry Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy Survival Rate Oncology Urinary Bladder Neoplasms Fluorouracil Toxicity Female Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | International journal of radiation oncology, biology, physics. 68(4) |
| ISSN: | 0360-3016 |
| Popis: | Purpose: To give an update on the long-term outcome of an intensified protocol of combined radiochemotherapy (RCT) with 5-fluorouracil (5-FU) and cisplatin after initial transurethral resection of bladder tumor (TURBT) with selective organ preservation in bladder cancer. Methods and Materials: One hundred twelve patients with muscle-invading or high-risk T1 (G3, associated Tis, multifocality, diameter >5 cm) bladder cancer were enrolled in a protocol of TURBT followed by concurrent cisplatin (20 mg/m2/day as 30-min infusion) and 5-FU (600 mg/m2/day as 120-h continuous infusion), administered on Days 1–5 and 29–33 of radiotherapy. Response to treatment was evaluated by restaging TURBT 4–6 weeks after RCT. In case of invasive residual tumor or recurrence, salvage cystectomy was recommended. Results: Ninety-nine patients (88.4%) had no detectable tumor at restaging TURBT; 71 patients (72%) have been continuously free from local recurrence or distant metastasis. Superficial relapse occurred in 13 patients and muscle-invasive recurrence in 11 patients. Overall and cause-specific survival rates for all patients were 74% and 82% at 5 years, respectively. Of all surviving patients, 82% maintained their own bladder, 79% of whom were delighted or pleased with their urinary condition. Hematologic Grade 3/4 toxicity occurred in 23%/6% and Grade 3 diarrhea in 21% of patients. One patient required salvage cystectomy due to a shrinking bladder. Conclusion: Concurrent RCT with 5-FU/cisplatin has been associated with acceptable acute and long-term toxicity. Overall and cause-specific survival rates are encouraging. More than 80% of patients preserved their well-functioning bladder. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|