Chauvet B, Félix-Faure C, Davin J L, Berger C, Vincent P, Reboul F
Clinique Sainte-Catherine, Avignon, France.
Cancer Radiother. 1998 Apr;2 Suppl 1:77s-81s.
Pilot study to assess treatment feasibility and results of a 2-drug chemotherapy (CT) regimen administered concurrently with radiotherapy (RT) for muscle-invasive bladder cancer.
Fourty-six patients were included into a prospective study from December 1992 to April 1996. The median age was 66 years. Thirty-seven percent of the patients had T3B-T4 tumors, and 46% had benefited from prior macroscopically complete transurethral resection (TUR). Pelvic irradiation consisted of 50.4 Gy in 28 fractions over 39 days. Concurrent CT consisting of cisplatin (80 mg/m2/d1) and 5-fluorouracil (800 mg/m2/d2 to 5) by continuous infusions (5-FU) was delivered during the first and fifth weeks of radiation therapy. Twenty-three patients received two additional courses of adjuvant CT with cisplatin, methotrexate and vinblastin (MCV).
The median follow-up was 38 months. The feasibility of concurrent CT-RT was excellent: 96% of the patients completed radiotherapy and 100% of them received the two courses of P-FU. The acute toxicity was mild: no hematological toxicity or renal toxicity over grade II, 4 cases of bowel or rectal reversible grade III toxicity and 2 cases of reversible grade III cystitis. A complete response was achieved in 30 out of the 42 evaluable patients (65.2%). Nine patients received an immediate salvage treatment (3 TUR, 3 additional radiotherapy and 3 cystectomies). Ten patients had local failure. Projected 3-year locoregional control was 49% for the 46 patients. Projected overall 3-year survival was 53%. Functional results were good for disease-free patients with preserved bladder: 1 grade I, 3 grade II, and no grade III cystitis.
Concurrent 2-drug chemoradiotherapy with cisplatin and 5-fluorouracil is feasible without major toxicity and offers a potentially curative and conservative treatment for patients with localized muscle-invasive bladder cancer.
进行一项初步研究，以评估两药联合化疗（CT）方案与放射治疗（RT）同时应用于肌层浸润性膀胱癌的治疗可行性及疗效。
1992年12月至1996年4月，46例患者纳入一项前瞻性研究。中位年龄为66岁。37%的患者患有T3B - T4期肿瘤，46%的患者曾接受过肉眼可见的完全经尿道切除术（TUR）。盆腔放疗剂量为50.4 Gy，分28次，在39天内完成。同步CT方案为顺铂（80 mg/m²/d1）和5 - 氟尿嘧啶（800 mg/m²/d2至d5）持续静脉输注（5 - FU），在放疗的第一周和第五周进行。23例患者接受了另外两个疗程的顺铂、甲氨蝶呤和长春碱辅助化疗（MCV）。
中位随访时间为38个月。同步CT - RT的可行性良好：96%的患者完成了放疗，100%的患者接受了两个疗程的5 - FU治疗。急性毒性较轻：无二级以上血液学毒性或肾毒性，4例出现肠道或直肠可逆性三级毒性，2例出现可逆性三级膀胱炎。42例可评估患者中有30例（65.2%）达到完全缓解。9例患者接受了即刻挽救性治疗（3例经尿道切除术、3例追加放疗和3例膀胱切除术）。10例患者出现局部复发。46例患者预计3年局部区域控制率为49%。预计3年总生存率为5
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