Clinical evaluation of the effect of bladder-sparing therapy combined with gemcitabine and cisplatin for muscle invasive bladder cancer

Abstract

Objectives To investigate clinical efficacy and adverse reactions of bladder-sparing therapy combined with emcitabine and cisplatin (GC) for muscle invasive bladder cancer (MIBC) . Methods 30 patients with MIBC underwent transurethral resection of the bladder tumor(TURBT) in our hospital from January 2008 to December 2010 were collected. The tumor staging was T2aN0M0~T3aN0M0 , and maximum tumor diameter was less than 4cm, single or multiple. The GC chemotherapy was given by gemcitabine (1000mg/m2 ) on day 1 and day 8, cisplatin (30mg/m2 ) on day 2 and day 4. The regimen was repeated every 21 days, Results 30 patients were followed up for average 36 months, 20 patients remained recurrence and metastasis free, 10 cases recurred, 2 cases recurred after 2 cycles of chemotherapy, and again underwent TURBT after four cycles of chemotherapy, without recurrence during follow-up.4 patients received radical cystectomy, 4 patients received radiotherapy after TURBT, and 2 patients died of tumor recurrence.No patients with serious side effects of chemotherapy were included and well tolerable. Conclusions Bladder-sparing therapy combined with gemcitabine and cisplatin in treatment of patients with muscle invasive bladder cancer who underwent TURBT, which would significantly improve the curative effect and reduce recurrence of tumor, compared with total cystectomy, which could be easily accepted by the patients, improve the quality of life of patients and provide a new way for the patients who unable or unwilling to underwent radical cystectomy. Key words: Urinary Bladder Neoplasms; Cystectomy; Cisplatin