INTRODUCTION:
Concurrent chemo-radiotherapy (CRT) plays an integral role in the definitive bladder preservation treatment of muscle invasive bladder cancer (MIBC). The role of induction neoadjuvant chemotherapy (NAC) prior to CRT is yet unclear.
AIM OF THE WORK
We aimed to compare the treatment outcomes of NAC followed by CRT versus definitive CRT in patients with MIBC undergoing bladder preservation.
MATERIALS & METHODS:
This is a retrospective study of 46 patients with MIBC who had undergone bladder preservation treatment after maximal transurethral tumor resection (TURBT) from Jan 2016 to Dec 2019. Patients were distributed into 2 groups; group A (n=23) received definitive CRT while group B (n=23) received 3 cycles induction NAC (Cisplatin 70 mg/m2 on day 1 and Gemcitabine 1000 mg/m2 on day 1 & 8) 21-day apart prior to CRT. In both groups, 3D conformal RT total bladder dose was up to 60-65Gy using conventional fractionation concurrent with weekly cisplatin (40mg/m2). Response assessment and patient follow-up were done by cystoscopy with biopsy and CT scan. The primary outcomes were ORR, mean DFS and two-year OS. Survival data was determined by Kaplan–Meier estimator, statistical inferences by the log-rank test and multivariate analysis by multiple linear regression. Treatment related adverse events were reported following NCI-CTCAE v4.0.