Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study

Autor: Oliver Riesterer, Adela Ademaj, Emsad Puric, Brigitte Eberle, Marcus Beck, Silvia Gomez, Dietmar Marder, Eva Oberacker, Susanne Rogers, Roger A. Hälg, Thomas Kern, Sonja Schwenne, Jürgen Stein, Emanuel Stutz, Olaf Timm, Sebastian Zschaeck, Mathias S. Weyland, Paraskevi D. Veltsista, Stephen Wyler, Peter Wust, Stephan Scheidegger, Stephan Bodis, Pirus Ghadjar
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Hyperthermia, Vol 39, Iss 1, Pp 1078-1087 (2022)
Druh dokumentu: article
ISSN: 02656736
1464-5157
0265-6736
DOI: 10.1080/02656736.2022.2109763
Popis: Background Transurethral resection of bladder tumor (TUR-BT) followed by chemoradiation (CRT) is a valid treatment option for patients with muscle-invasive bladder cancer (MIBC). This study aimed to investigate the efficacy of a tetramodal approach with additional regional hyperthermia (RHT).Methods Patients with stages T2–4 MIBC were recruited at two institutions. Treatment consisted of TUR-BT followed by radiotherapy at doses of 57–58.2 Gy with concurrent weekly platinum-based chemotherapy and weekly deep RHT (41–43 °C, 60 min) within two hours of radiotherapy. The primary endpoint was a complete response six weeks after the end of treatment. Further endpoints were cystectomy-free rate, progression-free survival (PFS), local recurrence-free survival (LRFS), overall survival (OS) and toxicity. Quality of life (QoL) was assessed at follow-up using the EORTC-QLQ-C30 and QLQ-BM30 questionnaires. Due to slow accrual, an interim analysis was performed after the first stage of the two-stage design.Results Altogether 27 patients were included in the first stage, of these 21 patients with a median age of 73 years were assessable. The complete response rate of evaluable patients six weeks after therapy was 93%. The 2-year cystectomy-free rate, PFS, LRFS and OS rates were 95%, 76%, 81% and 86%, respectively. Tetramodal treatment was well tolerated with acute and late G3–4 toxicities of 10% and 13%, respectively, and a tendency to improve symptom-related quality of life (QoL) one year after therapy.Conclusion Tetramodal therapy of T2–T4 MIBC is promising with excellent local response, moderate toxicity and good QoL. This study deserves continuation into the second stage.
Databáze: Directory of Open Access Journals
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