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J Korean Soc Ther Radiol Oncol > Volume 25(2); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(2): 70-78.
Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer
Jeong Il Yu, Won Park, Dong Ryol Oh, Seung Jae Huh, Han Yong Choi, Hyon Moo Lee, Seong Soo Jeon, Ho Young Yim, Won Suk Kim, Do Hoon Lim, Yong Chan Ahn
1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonro.park@samsung.com
2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment.
Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range 38~86 years). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range 55.8~67 Gy). The survival rate was calculated by the Kaplan-Meier method.
An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range 3~91 months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy.
The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.
Key Words: Bladder cancer, Bladder preserving treatment, Radiotherapy
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