Voskuilen, Charlotte S. and van de Kamp, Maaike W. and Schuring, Nannet and Mertens, Laura S. and Noordzij, Arjen and Pos, Floris and van Rhijn, Bas W. G. and van der Heijden, Michiel S. and Schaake, Eva E. (2020) Radiation with concurrent radiosensitizing capecitabine tablets and single-dose mitomycin-C for muscle-invasive bladder cancer: A convenient alternative to 5-fluorouracil. RADIOTHERAPY AND ONCOLOGY, 150. pp. 275-280. ISSN 0167-8140, 1879-0887
Full text not available from this repository. (Request a copy)Abstract
Background and purpose: Chemoradiation (CRT) with mitomycin-C (MMC) and 5-fluorouracil (5-FU) has been shown to be superior to radiation alone in patients with muscle-invasive bladder cancer (MIBC). MMC/capecitabine is an effective replacement for 5FU as a radiosensitizer in other malignancies but has not been studied in bladder cancer. We evaluated the outcomes of MIBC patients treated with concurrent radiation and MMC/capecitabine. Materials and methods: MIBC patients treated with CRT (60 Gy in 5 weeks with single-dose MMC and capecitabine orally twice daily) between 2014 and 2019 were identified. Acute (<90 days) and late toxicity were registered. Endpoints were clinical complete response (cCR) in the bladder assessed by cystoscopy 3 months after CRT, locoregional disease-free survival (LDFS) and the number of salvage cystectomies. Results: We analysed 71 cT2-4aN0-2 M0 MIBC patients (median age 70 years). Twenty-one (30%) patients received neoadjuvant or induction chemotherapy and 14 (20%) patients underwent a pelvic lymph node dissection prior to CRT. All patients received the full dose of planned radiation. Seven (10%) patients experienced acute grade 3-4 toxicities and 2 (3%) patients experienced late grade 3-4 toxicities. Sixty-eight (96%) patients achieved cCR. Eight (11%) patients had a bladder recurrence, of whom 3 (4%) required salvage cystectomy. Two-year LDFS was 79% (95% CI: 68-88) at a median follow-up of 23 (95% CI: 17-28) months. Conclusion: Radiation with concurrent MMC/capecitabine is a well-tolerated bladder-sparing treatment. Severe toxicity is infrequent and locoregional tumor control and short-term disease free survival appear similar to previous studies with MMC/5FU. (c) 2020 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | THERAPY; CHEMOTHERAPY; CYSTECTOMY; OUTCOMES; Bladder cancer; Bladder preservation; Bladder-sparing; Chemoradiation; Trimodality therapy; Urothelial carcinoma |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Mar 2021 10:02 |
| Last Modified: | 12 Mar 2021 10:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/43899 |
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