POL Scientific / Bladder / Volume 11 / Issue 2 / DOI: 10.14440/bladder.2024.0028
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RESEARCH ARTICLE

Bladder preservation with concurrent chemoradiotherapy for muscle-invasive bladder cancer: Retrospective comparison of three regimens

Makito Miyake1* ,  Yusuke Iemura2 ,  Yuki Oda1 ,  Tatsuki Miyamoto3 ,  Nobutaka Nishimura1 ,  Masaki Haramoto3 ,  Kaoru Yamaki4 ,  Isao Asakawa4 ,  Satoshi Anai1,5 ,  Kiyohide Fujimoto1
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1 Department of Urology, Nara Medical University, Kashihara, Nara, Japan
2 Department of Urology, Yamatotakada Municipal Hospital, Yamatotakada, Nara, Japan
3 Department of Urology, Kouseikai Takai Hospital, Tenri, Nara, Japan
4 Department of Radiation Oncology, Nara Medical University, Kashihara, Nara, Japan
5 Department of Urology, Nara Prefectural Seiwa Medical Center, Ikoma, Nara, Japan
Bladder 2024 , 11(2), e21200009; https://doi.org/10.14440/bladder.2024.0028
Submitted: 4 August 2024 | Accepted: 2 September 2024 | Published: 12 September 2024
© 2024 by the Bladder published by POL Scientific. Licensee POL Scientific, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Objectives: The objectives of the study are to evaluate the oncological and functional outcomes of three bladder preservation regimens: radiotherapy alone (RT-alone group), concurrent chemoradiotherapy (CRT) using gemcitabine plus platinum (GP-RT group), and low-dose gemcitabine (LD-Gem-RT group) for muscle-invasive bladder cancer. Methods: The three oncological outcomes, bladder-intact distant metastasis-free survival (BI-DMFS), cancer-specific survival, and overall survival (OS), were compared among RT alone (n = 10), GP-RT (n = 16), and LD-Gem-RT (n = 11) groups. Treatment-related adverse events were evaluated against the Common Terminology Criteria for Adverse Events (version 5.0). In the LD-Gem-RT group, time-course changes in the domains and scales related to the quality of life were evaluated by utilizing three questionnaires. Results: Age was significantly higher in the RT alone group (84 ± 7.2 years old) than in the GP-RT (74 ± 9.0) and LD-Gem-RT (75 ± 6.7) groups (P = 0.016). At a median follow-up of 26 months, the 2-year BI-DMFS rates were 80, 81, and 55% in the RT alone, GP-RT, and LD-Gem-RT groups, respectively, and the 2-year OS rates were 69, 62, and 81%, respectively. In the CRT groups, only the baseline CRP ≥ 1.0 mg/dL was associated with poor survival outcomes. Common early-onset adverse events included diarrhea, urinary frequency, and hematotoxicity. A questionnaire survey in the LD-Gem-RT group revealed patients experienced significant deterioration in the global health status/quality of life and the physical component summary score. Conclusion: We reported the oncological and functional outcomes of bladder preservation therapy using three different regimens, yielding acceptable outcomes.

Keywords
Muscle invasive bladder cancer
Bladder preservation
Chemotherapy
Radiotherapy
Outcomes
Funding
None.
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Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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