Objective: To study chemotherapy practice in invasive bladder cancer in a cancer centre (Centre Léon Bérard).
Material and methods: This retrospective study concerned all patients treated by chemotherapy between 1994 and 2000, either in the adjuvant setting (38) or for metastatic disease (66).
Results: Twenty four of the 38 patients receiving adjuvant chemotherapy were treated with MVAC, 21% developed febrile neutropenia and 60% relapsed. The median recurrence-free survival was 12 months. In patients treated for metastatic disease, the objective response rate was 36% and the median survival with advanced disease after chemotherapy was 10 months. These results are in line with those reported in large-scale randomized trials. The toxicity of chemotherapy was also fairly high (21% of febrile neutropenia).
Conclusion: Prospective studies help to optimize chemotherapy protocols, but practice studies show the limited results and the high toxicity. The benefit/risk ratio must be carefully considered.