Neoadjuvant chemotherapy and hyperfractionated radiation therapy for the urinary bladder carcinoma

The standard treatment for an invasive bladder cancer is radical surgery; however, the quality of life of the patients who undergo total cystectomy is unfavorable even when the ileal conduits were constructed. We carried out a bladder-conserving treatment for 8 bladder cancer patients by using a hyperfractionated radiotherapy together with low dose of cis-platinum or carboplatinum daily as a radiosensitizer following trans-urethral tumor resection and neoadjuvant chemotherapy. Cystoscopic findings and biopsies at one month after completing radiation showed complete remission (CR) and partial response (PR) for 5 and 3 patients, respectively. All of the PR cases had T4 tumors and the patients with tumors smaller than T3 and without lymph node metastasis achieved CR. All patients completed radiotherapy without acute severe complications. Six patients have remained alive for more than 10 months and radiation induced late complications such as bladder or intestinal insufficiency have not been observed thus far.