RESUMEN
This study included 16 patients with muscle invasive transitional cell carcinoma of the urinary bladder. All were males with median age of 60 years. Bilharzial association was seen in nine cases [56%]. The majority had T2 and N0 disease [94%]. This study attempted complete transuretheral resection of the tumor [TURT] in all cases, but it was possible in nine cases [56%]. This was followed by two cycles of cisplatinum concurrent with pelvic radiation for 45 Gy. Interval cystoscopic assessment was done for each case. Eleven patients [69%] achieved complete histologic response and continued on further radiation of the bladder for 15 Gy with cisplatinum. The other five cases were referred for cystectomy, that was possible in three cases, the other two cases continued on the same scheme of chemoradiation. The treatment was reasonably tolerated by the majority of cases, vomiting was the commonest toxicity observed in 13 patients [81%]. The final outcome of the bladder-sparing protocol was nine patients [56%] alive with preserved bladder. Incomplete TURT and replacing cisplatin by carboplatin had significant poor impact on disease local control