Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study

Transurethral resection of bladder tumor (TUR-BT) followed by chemoradiation (CRT) is a valid treatment option for patients with muscle-invasive bladder cancer (MIBC). This study aimed to investigate the efficacy of a tetramodal approach with additional regional hyperthermia (RHT). Patients with sta...

Full description

Saved in:

Bibliographic Details
Published in:	International journal of hyperthermia Vol. 39; no. 1; pp. 1078 - 1087
Main Authors:	Riesterer, Oliver, Ademaj, Adela, Puric, Emsad, Eberle, Brigitte, Beck, Marcus, Gomez, Silvia, Marder, Dietmar, Oberacker, Eva, Rogers, Susanne, Hälg, Roger A., Kern, Thomas, Schwenne, Sonja, Stein, Jürgen, Stutz, Emanuel, Timm, Olaf, Zschaeck, Sebastian, Weyland, Mathias S., Veltsista, Paraskevi D., Wyler, Stephen, Wust, Peter, Scheidegger, Stephan, Bodis, Stephan, Ghadjar, Pirus
Format:	Journal Article
Language:	English
Published:	Taylor & Francis 31-12-2022 Taylor & Francis Group
Subjects:	Bladder cancer bladder preservation radiochemotherapy regional hyperthermia tetramodal therapy
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Transurethral resection of bladder tumor (TUR-BT) followed by chemoradiation (CRT) is a valid treatment option for patients with muscle-invasive bladder cancer (MIBC). This study aimed to investigate the efficacy of a tetramodal approach with additional regional hyperthermia (RHT). Patients with stages T2-4 MIBC were recruited at two institutions. Treatment consisted of TUR-BT followed by radiotherapy at doses of 57-58.2 Gy with concurrent weekly platinum-based chemotherapy and weekly deep RHT (41-43 °C, 60 min) within two hours of radiotherapy. The primary endpoint was a complete response six weeks after the end of treatment. Further endpoints were cystectomy-free rate, progression-free survival (PFS), local recurrence-free survival (LRFS), overall survival (OS) and toxicity. Quality of life (QoL) was assessed at follow-up using the EORTC-QLQ-C30 and QLQ-BM30 questionnaires. Due to slow accrual, an interim analysis was performed after the first stage of the two-stage design. Altogether 27 patients were included in the first stage, of these 21 patients with a median age of 73 years were assessable. The complete response rate of evaluable patients six weeks after therapy was 93%. The 2-year cystectomy-free rate, PFS, LRFS and OS rates were 95%, 76%, 81% and 86%, respectively. Tetramodal treatment was well tolerated with acute and late G3-4 toxicities of 10% and 13%, respectively, and a tendency to improve symptom-related quality of life (QoL) one year after therapy. Tetramodal therapy of T2-T4 MIBC is promising with excellent local response, moderate toxicity and good QoL. This study deserves continuation into the second stage.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0265-6736 1464-5157
DOI:	10.1080/02656736.2022.2109763