eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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SCImago Journal & Country Rank
1/2023
vol. 27
 
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abstract:
Original paper

Bladder preservation by neoadjuvant chemotherapy followed by concurrent chemoradiation for muscle-invasive bladder cancer

Dalia Hamouda Elsayed
1
,
Ola M. Elfarargy
1
,
Mohamed Salah Elderey
2
,
Doaa Mandour
3
,
Nora Atef
4
,
Rehab Hemeda
3
,
Mostafa Kamel
2
,
Ahmed Azony
3
,
Heba F. Taha
1

  1. Medical Oncology Department, Zagazig University, Zagazig, Egypt
  2. Urology Department, Zagazig University, Zagazig, Egypt
  3. Clinical Oncology and Nuclear Medicine Department, Zagazig University, Zagazig, Egypt
  4. Cancer Epidemiology and Biostatistics National Cancer Institute, Cairo University, Cairo, Egypt
Contemp Oncol (Pozn) 2023; 27 (1): 1–9
Online publish date: 2023/04/18
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Introduction:
In Egypt, bladder cancer (BC) represents about 8.7% of cancers in both sexes. In Egyptian men, it accounts for over 30% of all cancers, which makes it the second most frequent cancer. The standard curative treatment for patients with muscle-invasive bladder cancer (MIBC) has been radical cystectomy (RC) with urinary diversion and pelvic lymphadenectomy. Concomitant chemoradiation therapy (CCRT) in MIBC appears to produce results that are comparable to those of RC.

Material and methods:
Between January 2018 and March 2021, 34 BC- diagnosed patients, who refused RC, were enrolled. They received transurethral resection of the bladder tumour (TURBT) followed by 3 cycles of neoadjuvant chemotherapy (NACT) with gemcitabine, cisplatin, and CCRT. Concomitant chemoradiation therapy with cisplatin, as a chemosensitizer, was administered to patients who experienced a complete response (CR) and a partial response (PR) ≥ 50%.

Results:
Following NACT, CCRT was given to 27 patients (79.45%) who had either a PR > 50% or CR. Seven patients (20.5%) showed PR below 50%, stable disease, or progressive disease; 4 of them underwent RC followed by postoperative radiation. The average follow-up period was 46 months (range: 6–52 months). Twenty-three patients (67.6%) were still alive at the last check-up. Disease-free survival and 3-year overall survival were 70.8% and 65.1%, respectively.

Conclusions:
Bladder preservation provides survival rates comparable to those of MIBC patients, but with a higher quality of life. The findings show good survival rates without metastasis; nevertheless, more multicentre trials with larger sample sizes and longer follow-up periods are required to confirm these findings.

keywords:

neoadjuvant chemotherapy, bladder preservation, concurrent chemoradiotherapy, muscle-invasive bladder cancer

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