Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer.
- Author:
Jeong Il YU
1
;
Won PARK
;
Dong Ryol OH
;
Seung Jae HUH
;
Han Yong CHOI
;
Hyon Moo LEE
;
Seong Soo JEON
;
Ho Young YIM
;
Won Suk KIM
;
Do Hoon LIM
;
Yong Chan AHN
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonro.park@samsung.com
- Publication Type:Original Article
- Keywords:
Bladder cancer;
Bladder preserving treatment;
Radiotherapy
- MeSH:
Chemoradiotherapy;
Clinical Protocols;
Cystoscopy;
Disease-Free Survival;
Female;
Humans;
Male;
Radiotherapy;
Recurrence;
Survival Rate;
Urinary Bladder Neoplasms*;
Urinary Bladder*
- From:The Journal of the Korean Society for Therapeutic Radiology and Oncology
2007;25(2):70-78
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. MATERIALS AND METHODS: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range 38~86 years). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range 55.8~67 Gy). The survival rate was calculated by the Kaplan-Meier method. RESULTS: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range 3~91 months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. CONCLUSION: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.