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Bladder cancer: chemotherapy plus radiation, an alternative to surgery


Adding chemotherapy to radiation therapy for muscle invasive bladder cancer allows 67% of people to be free of disease in their bladders two years after treatment. This compares to 54% of people who receive radiation alone.

The trial has shown that this treatment offers improved control of cancer within the bladder with acceptable long-term side effects and is therefore a viable alternative to radical surgery in patients with muscle invasive bladder cancer.

Bladder cancer affects about 70,000 Americans each year. It is four times more common in men than in women and two times more common in Caucasians than African-Americans. Cure rates for advanced bladder cancer are generally poor, with only around 40% of those with this form of the disease living more than five years after diagnosis.

In the United States, the most common treatment for advanced bladder cancer is complete removal of the bladder, which compromises patients' normal urinary function. Radiotherapy has been used as an alternative for some time. Doctors have been making advances in combining radiation therapy and chemotherapy as a way to treat bladder cancer while allowing patients an opportunity to maintain normal bladder function.

The multicenter randomized trial, conducted at 45 institutions in the United Kingdom, examined whether adding chemotherapy to radiation treatment is safe and more effective than giving radiation alone in preventing bladder cancer from returning. The trial also compared two ways of giving radiation therapy.

From August 2001 to April 2008, 458 invasive bladder cancer patients entered the trial. Results of the study show that the combination of chemotherapy and radiation treatment reduced the long-term risk of recurrence of cancer within the bladder, while also preserving bladder function. ( Xagena )

Source: 52nd Annual Meeting of the American Society for Radiation Oncology ( ASTRO ), 2010

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