Radiat Oncol J.  2015 Dec;33(4):294-300. 10.3857/roj.2015.33.4.294.

Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer

• Byun SJ
• Kim JH
• Oh YK
• Kim BH

• KMID: 2144291
• DOI: http://doi.org/10.3857/roj.2015.33.4.294

Abstract

PURPOSE
To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent.
MATERIALS AND METHODS
We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months).
RESULTS
Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS.
CONCLUSION
Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

Keyword

Urinary bladder neoplasm; Bladder preservation; Concurrent chemoradiotherapy; Radiotherapy; Survival rate; Prognostic factor

MeSH Terms

Chemoradiotherapy*
Disease-Free Survival
Drug Therapy
Follow-Up Studies
Humans
Joints
Multivariate Analysis
Radiotherapy
Retrospective Studies
Survival Rate
Urinary Bladder Neoplasms*
Urinary Bladder*