883 - Experience of organ preservation in urinary bladder

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Urothelial Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Pritanjali Singh
Authors P. Singh1, R.R. Prasad2
  • 1Reginal Cancer Centre, regional cancer centre , indira gandhi institute of medical sciences, 800014 - Patna/IN
  • 2Radiation Oncology, regional cancer centre , indira gandhi institute of medical sciences, 800014 - Patna/IN

Abstract

Aims

A retrospective analysis to evaluate the toxicity profile, protocol completion rate, tumor response rate, and disease free interval in patients undergoing chemoradiotherapy with muscle-invasive bladder cancer.

Materials and methods

Following transurethral resection of the tumor in patients with Stage T2-T4a bladder cancer, induction chemotherapy with paclitaxel and cisplatin / gemcitabine and cisplatin was administered for two–three cycles. Thereafter radiotherapy with low dose chemotherapy was administered with weekly review. Adjuvant chemotherapy based on the neoadjuvant protocol was given to all patients.

Results

Between May 2005 to April 2008 total of 109 patients database were available for review. Paclitaxel and cisplatin chemotherapy resulted in mildly grater grade 3-4 acute toxicity, mainly gastrointestinal (25%) as compared with gemcitabine and cisplatin 17%. Four cycles of adjuvant chemotherapy were completed per protocol or with minor deviations in 45% of the patients in both the arms together. Late bladder radiation toxicity was evaluated in 47 patients with >/ = 2 years of follow-up. Of these 47 patients, 3 experienced self-limited, late grade 3 bladder toxicity. The post induction complete response rate was 81% and 76% in the Paclitaxel and cisplatin group and gemcitabine and cisplatin group respectively. At a median follow-up of 39.4 months, the disease free survival was 69% and 71%, respectively.

Conclusions

These favorable tumor response rates with possible increased bladder preservation rates suggest that this treatment regimen deserves further study.

Disclosure

All authors have declared no conflicts of interest.