Bladder Preservation with Concurrent Radiotherapy and Gemcitabine following Maximal Transurethral Resection for Muscle Invasive Bladder Cancer: Single Institutional ExperienceMutahir A. Tunio*, Mushabbab Al Asiri, Mohsin Fareed, Shoaib Ahmed, Yasser Bayoumi and Abdullah Amro Department of
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia
- *Corresponding Author:
- Dr. Mutahir A. Tunio
MBBS, FCPS (Radiation Oncology) Assistant Professor
Department of Radiation Oncology
Comprehensive Cancer Center
King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia
Tel: +996 12889999
E-mail: [email protected]
Received January 19, 2012; Accepted February 16, 2012; Published February 20, 2012
Citation: Tunio MA, Asiri MA, Fareed M, Ahmed S, Bayoumi Y, et al. (2012) Bladder Preservation with Concurrent Radiotherapy and Gemcitabine following Maximal Transurethral Resection for Muscle Invasive Bladder Cancer: Single Institutional Experience. J Nucl Med Radiat Ther 3:121. doi:10.4172/2155-9619.1000121
Copyright: © 2012 Tunio MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract Objectives: For bladder preservation, cisplatinum is widely used radiosensitizer with concurrent chemoradiation (CRT). We aimed to evaluate the safety profile and potential benefit of gemcitabine as a radiosenistizer in bladder preservation.
Patients and methods: During July 2006 to January 2007, consecutive 32 patients with T2-T4N0M0 bladder cancer underwent transurethral resection of bladder tumor (TURBT) followed by concurrent chemoradiation with weekly gemcitabine 100 mg/m2 . Conformal radiotherapy was given with a shrinking field technique. Complete response was defined as no visible tumor on cystoscopy and biopsy.
Results: Of total, 26 patients received a median of 7 (3–8) cycles of gemcitabine and median cumulative radiation dose of 65 Gy. Grade 3 hematologic toxicities seen were; neutropenia (3.8%) and thrombocytopenia (7.7%). Grade 3 non-hematologic toxicities were; diarrhea (19.2%), nausea/vomiting (7.7%) and cystitis (15.4%). Complete response was achieved in 18 patients (69.2% [95% CI: 60–89%]). At median follow up of 36 months, four patients had local recurrences (two superficial and two muscle invasive). The overall intact bladder and overall survival rates were 75.1% and 56.3%, respectively. Conclusion: CRT with weekly gemcitabine was found feasible and highly active in the treatment of muscle invasive bladder cancer, as the 3 year intact bladder survival rates were promising.