Objective To evaluate the local control effect of radiotherapy and intravesical chemotherapy following bladder preserving surgery for musculoinvasive bladder cancer. Methods Twenty three patients with muscle invasive bladder cancer were treated by bladder preserving surgery followed by external radiation ( mean dose 52.5 Gy) combined with intravesical mitomycin infusion after bladder preserving operation (study group).For comparison, 29 similar patients received the same treatment without radiation served as control (control group).Results All patients in the study group completed their designed treatment,except two patients whose protocol was interrupted for 3 days and one week due to acute cystitis. The mean follow up duration was 41.6 months. The 3 year local recurrence rates were 18.8% in the study group and 44.8% in the control group(P=0.026).The 3 year distant metastasis rates were 18.2% and 24.1% (P=0.437),and the 3 year overall survival rates were 81.8% and 86.2% (P=0.670),respectively. Conclusion It is demonstrated that adjuvant radiotherapy and intravesical infusion chemotherapy following organ preserving surgical procedure are encouraging by giving favorable local control for musculoinvasive bladder cancer.

OBJECTIVETo analyze the efficacy of recurrence prophylaxis using radiation and chemotherapy following bladder conservation surgery for muscle invasive bladder cancer.

METHODS23 patients with muscle invasive bladder cancer were treated with radiotherapy combined with bladder mitomycin infusion after bladder conservation surgery (study group). Radiotherapy was given using an external beam at an average dose of 5148 +/- 462 cGy with conventional fractionation. For comparison, 29 similar patients treated with postoperative bladder mitomycin infusion without radiation served as control (control group). All patients were followed up for more than 3 years, an average of 41.6 months (36 - 60 months).

RESULTSThe 3-year pelvic recurrent rate of muscle invasive bladder cancer was 17.4% in the study group and 44.8% (P = 0.036) in the control group. The 3-year distant metastasis rates were 17.4% and 24.1%, respectively (P = 0.554). The 3-year overall survival rates were 81.8% and 86.2%, respectively (P = 0.670). Two patients from the study group had their treatment interrupted, one for 3 days and the other for one week due to acute cystitis, while the rest of the patients were able to complete the treatment according to schedule.

CONCLUSIONRadiotherapy plus chemotherapy after bladder conservation surgery for muscle invasive bladder cancer can decrease the rate of pelvic recurrence effectively and be used as a realistic adjuvant treatment.

Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate ; Urinary Bladder Neoplasms ; mortality ; therapy