[Concomitant radiochemotherapy in invasive bladder tumors]

Bull Cancer. 1997 Apr;84(4):405-11.
[Article in French]

Abstract

The treatment of muscle-invasive bladder tumors currently consists of radical cystectomy with lymph node dissection. A combined radio-chemotherapy treatment could allow to preserve a functional bladder without greater risk of relapse. We present a review of 38 available publications found in the international literature concerning this combination treatment. Only 9 publications with appropriate analysis were considered, including 552 evaluable patients, 44% of whom were suitable for radical cystectomy. Cisplatin is the most often used drug. The protocols are variable and generally well tolerated. The median follow-up time is 36 months. The immediate complete response rates vary between 48 and 92% and the overall survival rate is between 42 and 82%. The survival with bladder preservation is between 38 and 75%, while the disease-free survival with bladder preservation is between 33 and 53%. 11% of the initially complete responders had a superficial recurrence and 30% had distant metastases. There is no proven advantage of neoadjuvant polychemotherapy, there is no consensus for the therapeutical protocol, the follow-up protocol remains to be defined, and the function of the preserved bladder has to be studied. Only a prospective randomized trial could precise the role of this experimental technique compared to surgery despite the major evident difficulties (ethical and practical) to conduct such a trial.

Publication types

  • English Abstract
  • Multicenter Study
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Combined Modality Therapy
  • Humans
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy Dosage
  • Survival Analysis
  • Treatment Outcome
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / radiotherapy*

Substances

  • Cisplatin