TUR followed by systemic chemotherapy then local radiation therapy with adjunct cisplatinum in locally advanced bladder cancer- a preliminary report

ABSTRACT

Between February, 1989 and September, 1991, 15 patients with proved diagnosis muscle-invading transitional cell carcinoma of the urinary bladder were enrolled in a treatment protocol in Jeddah Cancer Center consisting of maximal transurethral tumour resection followed by 4 cycles of systemic chemotherapy using M-VAC regimen then combined full dose external-beam irradiation and two extracisplatinum doses. Only 14 patients completed the previous protocol. All evaluable patients showed a complete clinical response at the end of the planned combined approach [with a response rate of 100 percent] which has been successfully maintained for a median follow-up period of 15 months [range from 6 to 31 months]. Toxicity was acceptable and manageable. This preliminary report suggests that the combined multi-modality therapy is highly effective in locally advanced bladder cancer. Longer follow-up is still required to conclude whether this approach can become an alternative to radical cystectomy in such cases