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. 2015 Dec;33(4):294-300.
doi: 10.3857/roj.2015.33.4.294. Epub 2015 Dec 30.

Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer

Sang Jun Byun  1 , Jin Hee Kim  2 , Young Kee Oh  2 , Byung Hoon Kim  3
Affiliations

Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer

Sang Jun Byun et al. Radiat Oncol J. 2015 Dec.

Abstract

Purpose: To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent.

Materials and methods: We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months).

Results: Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS.

Conclusion: Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

Keywords: Bladder preservation; Concurrent chemoradiotherapy; Prognostic factor; Radiotherapy; Survival rate; Urinary bladder neoplasm.

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Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Overall survival (OS) and disease-free survival (DFS) curves.
Fig. 2
Fig. 2. Overall survival (OS) curves according to concurrent chemotherapy. CCRT, concurrent chemotherapy and radiotherapy; RT, radiotherapy.
Fig. 3
Fig. 3. Overall survival (OS) curves according to tumor grade.
Fig. 4
Fig. 4. Disease-free survival (DFS) curves according to clinical TNM stage.
See this image and copyright information in PMC

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