The Results of Combined Modality Treatment with Transurethral Resection, Cisplatin and Radiation Therapy for Invasive Bladder Cancer

Oh, Yoon Kyeong

Abstract

Ten patients with deep muscle-invading bladder carcinoma (clinical stage T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the trmors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60% for all patients. The complete responses were achieved in 4 of 5(80%) with stage cT3a, in 2 of 3(67%) with stage cT3b and in none of 2(0%) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80%. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher cancer. Six patients who showed complete responses after treatment. Distant metastases developed in 3 patients : lungs in 2 (cT4b) of those who were never locally free of disease and spine in 1 patient follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.