Efficacy and safety of systemic chemotherapy and intra-arterial chemotherapy with/without radiotherapy for bladder preservation or as neo-adjuvant therapy in patients with muscle-invasive bladder cancer: A single-centre study of 163 patients
Male
Cystectomy
Carboplatin
03 medical and health sciences
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
Chemotherapy
Humans
Infusions, Intra-Arterial
Neoplasm Invasiveness
Preoperative treatment
Aged
Aged, 80 and over
Carcinoma, Transitional Cell
Radiotherapy
Bladder cancer
Chemoradiotherapy
Chemoradiotherapy, Adjuvant
Middle Aged
Prognosis
Neoadjuvant Therapy
3. Good health
Oncology
Chemotherapy, Adjuvant
Adverse events
Multivariate Analysis
Surgery
Female
Fluorouracil
Cisplatin
Organ Sparing Treatments
DOI:
10.1016/j.ejso.2014.07.043
Publication Date:
2014-09-28T13:02:49Z
AUTHORS (8)
ABSTRACT
Patients with muscle-invasive bladder cancer (MIBC) often undergo various preoperative treatments to improve survival; however, their efficacy and safety remain unclear.The anti-tumour effects and adverse events were evaluated in 163 MIBC patients who received systemic chemotherapy (SC, n = 34), intra-arterial chemotherapy (IAC, n = 50), or combined IAC and radiotherapy (IAC + R, n = 79).Pathological complete responses were observed in 17.6%, 22.0%, and 43.0% of patients in the SC, IAC, and IAC + R groups, respectively, with respective 5-year overall survival rates of 42.0%, 46.7%, and 50.3%. Multivariate analysis showed that successful IAC + R protocol administration was a significant predictor for survival (hazard ratio = 0.16, p = 0.028). The incidence of severe adverse events was higher in the IAC + R group (36.7%) than in the SC (9.8%) and IAC groups (16.0%).IAC + R was useful for patients with MIBC. Successful completion and optimal patient selection were important for this treatment strategy.
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