Comparison of sequential versus concurrent chemoradiation regimens in non-metastatic muscle-invasive bladder cancer

• 영문명: Comparison of sequential versus concurrent chemoradiation regimens in non-metastatic muscle-invasive bladder cancer
• 발행기관: 대한방사선종양학회
• 저자명: Heidi M. Vieira David P. Kasper Runqiu Wang Lynette M. Smith Charles A. Enke Raymond C. Bergan
• 간행물 정보: 『대한방사선종양학회지』제41권 제3호, 154~162쪽, 전체 9쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2023.09.30

영문 초록

Purpose: The treatment approach for non-metastatic bladder cancer is guided by an invasion of the muscular layer of the bladder wall. Radical cystectomy is the recommended treatment for muscle-invasive disease. However, it has considerable morbidity and mortality and is not suited for many patients. Trimodality therapy consisting of chemoradiation after transurethral resection of bladder tumor offers a definitive approach with bladder-sparing potential. However, there is a lack of research defining the optimal combination of chemotherapy and radiation in this setting. Materials and Methods: We extracted patient data from the National Cancer Database to compare survival outcomes and demographic factors in 2,227 non-metastatic bladder cancer patients who were treated with chemotherapy sequential to or concurrently with radiation. Sequential treatment was defined as chemotherapy beginning >14 days before radiation, and concurrent was defined as beginning within 14 days of the first radiation. Results: The sequential treatment group patients were younger (mean age, 74 vs. 78 years; p < 0.001) with more advanced disease. We found no difference in overall survival between patients who received chemotherapy sequential to radiation and those who received concurrent chemoradiation only (p = 0.533). Conclusion: Our data are concordant with a previous prospective study, and support that chemotherapy prior to radiation does not decrease survival outcomes relative to patients receiving only concurrent chemoradiation. Given that the sequential group had an overall higher stage but no difference in survival, downstaging chemotherapy prior to radiation may be helpful in these patients. Further studies including a larger, multi-institutional clinical trial are indicated to support clinical decision-making.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Funding

Author Contributions

Data Availability Statement

Supplementary Materials

References

키워드

Urinary bladder neoplasms Chemoradiotherapy Survival analysis