ABSTRACT
Purpose:To evaluate the efficacy of bladder p re servation treatment by concurrent neoadjuvant intra-arterial chemotherapy, radi otherapy and transurethral resection for patients with bladder cancer with muscl e invasion. Methods:Thirteen patients who were unfit for or unwilling to re ceive radical cystectomy were enrolled in this study. All patients had muscle in vasive transitional cell carcinoma of bladder(T 2-T 3). Patients were treated with neoadjuvant intra-arterial chemotherapy, radiotherapy and transurethral r esection. The chemotherapy regimen consisted of cisplatin 80 mg, epirubicin 50 m g and fluorouracil 1 g/camptothecin 30 mg. The average dose of radiotherapy was 30-50 Gy. Results:At the end of neoadjuvant therapy, 1 patient (7.69%) sh owed a complete response and 12 patients (92.31%) showed partial response; tran surethral resection was performed for residual tumors. All patients completed th e treatment and showed good tolerance. With a median follow-up of 26.46 months, local recurrence or distant metastasis occurred in 5 patients (38.46%). Recurre nt tumors were treated with transurethral resection or systematic chemotherapy a nd radiotherapy. Conclusions:concurrent neoadjuvant intra-arterial chemotherapy , radiotherapy and transurethral resection is a feasible and promising treatment for patients with bladder cancer with muscle invasion.
ABSTRACT
Purpose:To compare the survival rates of hyperf ractionated radiotherapy plus concurrent chemotherapy with hyperfractionated rad iotherapy alone in the treatment of stage Ⅲ/Ⅳ nasopharyngeal carcinoma (NPC) a nd analyze the prognostic factors. Methods:Between December 1992 and December 1995, 144 NPC patien ts were randomized into hyperfractionated radiotherapy plus concurrent chemother apy (R +C) and hyperfractionated radiotherapy alone (R alone).Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R + C patients before and during the course of radiotherapy. Results:The 5-year overall survival rates of the R + C and R alone groups were 63.3% and 50.7%,repectively . The factors influencing the resu lts were N stage,chemotherapy and the peripheral blood hemoglobin concentration . Conclusions:Hyperfractionated radiotherapy plus concurrent chem otherapy can improve the survival rate, especially for the patients with N2-N3 stage.The negative prognostic factors for Ⅲ/Ⅳ NPC are N2-N3 stage, radiothera py alone and the reduction of hemoglobin during treatment.