COMBINATION THERAPY OF TRANSURETHRAL RESECTION (TUR) AND RADIOTHERAPY IN ADVANCED BLADDER CANCER
1983 Volume 74 Issue 12 Pages 2043-2053
Details
1983 Volume 74 Issue 12 Pages 2043-2053
At the Department of Urology, Tokyo Jikeikai University, School of Medicine, since 1960 in treating T3 and T4 adavanced cancers of the bladder, in order to preserve bladder function, we have been combining transurethral resection (TUR) of bladder tumor with irradiation therapy. The results are as follows:
1. Subjects
During the 21 year period from the beginning of 1960 through 1980 we personally observed 183 patients with advanced cancers of the bladder but only 87 of these patients were treated with a combination of TUR and irradiation (66 cases with T3 and 21 cases with T4). These patients ranged in age from 41 to 83 years old with a mean age of 63. There were 70 males and 17 females.
2. Methods
During TUR, the tumorous focus was completely excised from within the bladder (except in cases of biopsy). External irradiation alone was applied starting from the 10th-14th day after TUR using either 60Co or Linac irradiation. The total dose to the bladder region ranged from 5000 to 7500 rads (6-8W).
3. Results
1) The therapeutic results of this combined treatment showed a 5 year survival rate of 46.9% for T3 cancer patients and 0% for T4 cancer patients so that the overall 5 year survival rate for both groups was 33.3%. This survival rate was significantly improved in comparison with the group of patients who was treated only with TUR. This combined method was only effective in stage T3 patients with relatively small sized tumors.
2) Side-effects due to the combined use of irradiation treatments
Acute responses were observed in almost all of the patients but they disappeared within 3 to 4 weeks after the completion of irradiation treatments. Late damage included contracted bladder, radiocystitis, radiation proctitis which were observed in 18.3% of these patients of which only 11.7% required surgical intervention.
3) Using this method of combined therapy, it was possible to preserve bladder function for 5 years in 66.7% of the cases.
