Comparison of Radical Cystectomy and Chemoradiotherapy in Patients with Locally Advanced Bladder Cancer

Ikeda, Masaomi; Matsumoto, Kazumasa; Nishi, Morihiro; Tabata, Ken-Ichi; Fujita, Tetsuo; Ishiyama, Hiromichi; Hayakawa, Kazushige; Iwamura, Masatsugu

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자료유형: 학술저널

저자정보: Ikeda, Masaomi (Department of Urology, Kitasato University School of Medicine) Matsumoto, Kazumasa (Department of Urology, Kitasato University School of Medicine) Nishi, Morihiro (Department of Urology, Kitasato University School of Medicine) Tabata, Ken-Ichi (Department of Urology, Kitasato University School of Medicine) Fujita, Tetsuo (Department of Urology, Kitasato University School of Medicine) Ishiyama, Hiromichi (Department of Radiology and Radiation Oncology, Kitasato University School of Medicine) Hayakawa, Kazushige (Department of Radiology and Radiation Oncology, Kitasato University School of Medicine) Iwamura, Masatsugu (Department of Urology, Kitasato University School of Medicine)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제16호

발행연도: 2014.1

수록면: 6,519 - 6,524 (6page)

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The aim of this study was to evaluate the clinical outcomes of radical cystectomy (RC) and concurrent chemoradiotherapy (CRT) with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with locally advanced bladder cancer (BC). From December 2000 to February 2012, 72 patients with locally advanced BC (T3-4a, N0 or N+, M0) received either RC or CRT. RC with bilateral pelvic lymph node dissection including the common iliac region as the standard procedure. Patients in the CRT group received one cycle of MVAC followed by radiotherapy with a half dose of MVAC and then two more cycles of MVAC. Standard fractionation at a daily dose of 1.8-2.0 Gy was used, with a median total dose of 50 Gy (range, 45-60 Gy). The 3-year progression-free survival (PFS) rates in the RC and CRT groups were 56.2% and 25.6%, respectively (p=-0.015) and the 3-year overall survival (OS) rates were 63.5% and 48.1% (p=0.272). Multivariate Cox proportional hazards regression analysis with application of a propensity score indicated that RC was a significant predictor of PFS (p=0.033) but not of OS (p=0.291). Among patients with locally advanced BC, PFS was significantly prolonged in the RC group compared with the CRT group. However, RC was not a significant predictor of OS. Although the sample size in this study was small, the results suggest that patient background and postoperative quality of life should be considered when choosing treatment strategy for locally advanced BC.

#Radical cystectomy #chemoradiotherapy #locally advanced bladder cancer #survival

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Ikeda, Masaomi

소속기관 Department of Urology, School of Medicine, Graduate School of Medical Sciences, Kitasato University