An organ-sparing treatment using combined intra-arterial chemotherapy and radiotherapy for muscle-invading XXXX .

@entity1 @entity41 @entity5 @entity900 @entity150 @entity1499
OBJECTIVE: We describe the results of an organ-sparing approach for the treatment of non-metastatic, invasive @entity150 . MATERIAL AND METHODS: Twenty-three @entity1 (mean age 71 years; age range 47-87 years) with @entity150 of clinical stage T2-T3N0M0 and histologically proven muscle invasion were examined between 1992 and 1998. The median duration of follow-up was 30 months. The treatment protocol for intra-arterial chemotherapy consisted of @entity1499 30 mg/m(2) and @entity900 50 mg/m(2) in 7 @entity1 and @entity900 50 mg/m(2) in 16 @entity1 , administered in three cycles via catheters inserted in the internal iliac arteries. Concomitantly, 41.4 Gy of radiotherapy was given to the lesser pelvis. Transurethral biopsy and urine cytology were performed after the completion of treatment; @entity1 were followed observationally if @entity41 was absent, and underwent radical cystectomy if it was present. RESULTS: At the end of treatment, 18 @entity1 (78%) showed a complete response (CR) and the bladder was spared in all cases. Radical cystectomy was performed for 4 non-CR cases, with the result that 2 cases had residual superficial @entity5 and the other 2 had muscle-invading @entity5 histologically. Among the @entity1 with a CR, 2 experienced intravesical recurrence. Overall, 2 @entity1 died of @entity5 , 5 died of other causes and 2 died during treatment. The 5-year disease-specific survival rate was 70.3% and the overall survival rate 46.4%. CONCLUSIONS: A bladder-sparing approach for the treatment of muscle-invading @entity150 which utilizes combined intra-arterial chemotherapy and radiotherapy may arrest the decline in quality of life induced by urinary diversion and yield equivalent therapeutic benefit to that of radical cystectomy.
