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Recently, organ-preserving regimens using predominantly multiple-modality therapy , consisting of endoscopic transurethral resection followed by irradiation with concurrent chemotherapy, are emerging as viable alternatives for muscle-invasive bladder cancer, although radical cystectomy has been the standard treatment. Three cases with muscle-invasive bladder cancer (5-7 cm in size) , two of T2N1M0 and one of T2NOMO, underwent bladder preservation therapy with regional hyperthermia for improvement of the local effect. A total dose of 66-7OGy in the conventional methods , chemotherapy composed of methotrexate, doxorubicin, cisplatin and/or vinblastine, and 3 to 12 sessions of hyperthermia during radiotherapy were delivered. All three cases showed complete response without any local recurrence or distant metastasis in follow-ups. Toxicity during the treatment was acceptable, and late toxicity was not recognized. Bladder preservation therapy adding regional hyperthermia is potentially useful for improving the treatment results for muscle-invasive bladder cancer of large tumor size. Key word : bladder cancer, chemotherapy, hyperthermia, radiotherapy Introduction Muscle-invasive tumors comprise 20 % to 25 % of all newly diagnosed bladder cancerso. The most appropriate treatment algorithm for muscle-invasive bladder cancer remains controversial. Although radical cystectomy has been the standard treatment for two decades, organ-preserving regimens using predominantly multiple-modality therapy, consisting of endoscopic transurethral resection (TUR) followed by irradiation with concurrent chemotherapy, are emerging as viable alternatives in a subset of patients. A major limitation of pelvic external beam radiation therapy is that the dose required to achieve an adequate level of local control in such tumors exceeds the tolerance of the surrounding normal tissues . Received 9 Febrary 2005, Accepted 8 March 2005. *Corresponding author, Tel : +81-93-691-7264 ; Fax : 4-81-93-692-0249 ; E-mail : ogurieye@med.uoeh-u.ac.jp

Initial Experience of Bladder Preservation Therapy Using Chemoradiotherapy with Regional Hyperthermia for Muscle-invasive Bladder Cancer