Trimodality therapy in bladder cancer: who, what, and when?

Urol Clin North Am. 2015 May;42(2):169-80, vii. doi: 10.1016/j.ucl.2015.02.002.

Abstract

Radical cystectomy is a standard treatment of nonmetastatic, muscle-invasive bladder cancer. Treatment with trimodality therapy consisting of maximal transurethral resection of the bladder tumor followed by concurrent chemotherapy and radiation has emerged as a method to preserve the native bladder in highly motivated patients. Several factors can affect the likelihood of long-term bladder preservation after trimodality therapy and therefore should be taken into account when selecting patients. New radiation techniques such as intensity modulated radiation therapy and image-guided radiation therapy may decrease the toxicity of radiotherapy in this setting. Novel chemotherapy regimens may improve response rates and minimize toxicity.

Keywords: Bladder preservation; Chemoradiation; Muscle-invasive bladder cancer; Radiation; Urothelial carcinoma of the bladder.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Checklist
  • Combined Modality Therapy / methods
  • Cystectomy
  • Humans
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Organ Sparing Treatments / methods
  • Patient Selection
  • Radiotherapy, Image-Guided
  • Radiotherapy, Intensity-Modulated
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / therapy*

Substances

  • Antineoplastic Agents