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Purpose:Radical cystectomy with or without chemotherapy is the most commonly recommended treatment for patients with muscle-invasive bladder cancer. Bladder preservation therapy by concurrent chemo-radiation is another promising option for many patients deemed unsuited for surgery. We evaluated the feasibility, efficacy and the outcomes of our own experience with concurrent chemo-radiation in muscle-invasive bladder cancer and we give a critical analysis and an overview of the current treatment protocol from other institutions. Materials and Methods:Forty-six patients who were unfit for or unwilling to receive radical cystectomy were enrolled in this study. All patients had transitional cell carcinoma of bladder, and distribution of stage was 3(6%), 21 (46%), 7 (15%) and 15 (33%) for T1, T2, T3 and T4, respectively. Treatment consisted in a transurethral resection of bladder tumor as complete as feasible followed by curative concurrent chemoradiation. Results:Twenty-nine patients showed complete response (CR), 22 of whom (48%) had a continuously tumor free bladder. With a median follow-up of 30 months (12–92 months), the 3-year overall survival (OS) was 50%; Local recurrence-free survival (LRFS) was 59% at 3 years and the distant metastases free survival (MFS) was 62% at 3 years. Conclusion:Concurrent chemo-radiation is a safe alternative to radical cystectomy for selected patients who wish to preserve the bladder. Our results emphasize that it’s feasible and promising, even in relatively older patients.

Bladder-Preservation Therapy in Muscle-Invasive Bladder Cancer: A Single Centre Experience