Author/Editor		Kragelj, Borut
Title		Kemoradioterapija invazivnih karcinomov sečnega mehurja
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2003
Volume		str. 147
Language		slo
Abstract		OBJECTIVE Radiotherapy (RT) with transurethral resection (TUR) combined with chemoterapy (ChT) gives an opportunity to bladder sparring approach of invasive transitional cell bladder carcinoma (TCC). Presented are long-term results. MATERIAL AND METHODS Analysed are data of 178 patients (pts) with TCC, stage T1 - T4, NO - N1, M0, treated in the prospective nonrandomized trial in the period 1987 - 1994 with TUR and concurrent (protocol 1) or sequential (protocol 2) chemoradiotherapy. Protocol 1 (84 pts) consisted of radiation (total tumor dose 63,6 - 64 Gy) and concurrent Cht with vinblastine (2mg/ 6-12 h iv. infusion weekly); protocol 2 consisted of 4 cycles of upfront Cht with methotrexate (30 mg/m2, days 1, 14), cisplatin (100 mg/m2 day 2), vinblastine (3mg/ m2 days 1,14) with or without adriablastine 30 mg/m2, days 1 or 2) and either ra.diotherapy (76 pts with complete remission at early evaluation or contraindications for cystectomy - TD for complete remission is 50 Gy; and for incomplete remission TD is 60 Gy) or cystectomy (18 pts). RT in the protocol 1 consisted of two different regimes - standard (43 pts) and accelerated (41 pts) with the median reduction of treatment time in the acclerated arm of 25 days. RESULTS Mean follow-up of living pts was 10,4 years. Estimated 9-year overall, cancer specific and progression-free survival rates were 32%, 49% and 39% respectively. Disease progression was the consequence of local recurrence in 65%, distant metastases in 30% and both in 5% of pts. Estimated rate of retained urinary bladder without progressive disease at 9 years was 45,2%. (Abstract truncated at 2000 characters).
Descriptors		BLADDER NEOPLASMS NEOPLASM STAGING VINBLASTINE ANTINEOPLASTIC AGENTS, COMBINED METHOTREXATE CISPLATIN DOXORUBICIN SURVIVAL ANALYSIS