Combined treatment approaches in regionally advanced bladder cancer.

Abstract

Multimodal therapy for locally advanced bladder carcinoma is being pursued in a wide diversity of protocols at this same time. While a number of innovative approaches are being explored, neoadjuvant and adjuvant chemotherapy in conjunction with cystectomy remains the dominant approach. The M-VAC regimen has become the dominant combination for the treatment of advanced bladder cancer; its use in an adjunctive setting is a logical progression. Although it is capable of effecting a response in the primary bladder lesion in a high percentage of cases, it is still not known whether survival will be enhanced. The use of radiosensitizing cytotoxics in conjunction with neoadjuvant chemotherapy, when combined with external-beam radiotherapy, is a provocative new approach that attempts to achieve both bladder salvage and enhanced patient survival. Completion of well-designed randomized studies will be necessary to determine whether these therapeutic innovations will yield any clinical benefit.

• Authors: P J Walther
• Journal: The Urologic clinics of North America (Urol Clin North Am) Vol. 19 Issue 4 Pg. 761-74 (Nov 1992) ISSN: 0094-0143 [Print] United States
• PMID: 1441030 (Publication Type: Journal Article, Review)

Chemical References

• Radiation-Sensitizing Agents
• Vinblastine
• Doxorubicin
• Cisplatin
• Methotrexate

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Transitional Cell (therapy)
• Chemotherapy, Adjuvant
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Cystectomy
• Doxorubicin (administration & dosage)
• Humans
• Methotrexate (administration & dosage)
• Radiation-Sensitizing Agents
• Urinary Bladder Neoplasms (therapy)
• Vinblastine (administration & dosage)