MP15-11 BLADDER PRESERVATION IN ELDERLY PATIENTS HAVING NON-MUSCLE INVASIVE HIGH GRADE RECURRENT TA, T1 UROTHELIAL CARCINOMA WITH GEMCITABINE, PACLITAXEL, DOXORUBICIN AND RADIOTHERAPY: SURVIVAL AND QUALITY OF LIFE.

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2017MP15-11 BLADDER PRESERVATION IN ELDERLY PATIENTS HAVING NON-MUSCLE INVASIVE HIGH GRADE RECURRENT TA, T1 UROTHELIAL CARCINOMA WITH GEMCITABINE, PACLITAXEL, DOXORUBICIN AND RADIOTHERAPY: SURVIVAL AND QUALITY OF LIFE. Mohamed Wishahi, Hossam Elganzoury, and Amr Elkhouly Mohamed WishahiMohamed Wishahi More articles by this author , Hossam ElganzouryHossam Elganzoury More articles by this author , and Amr ElkhoulyAmr Elkhouly More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.496AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES INTRODUCTION: Non-muscle invasive carcinoma of the bladder (NMICB) of high grade Ta, T1 tumor that recurred after Intavesical BCG, had a high incidence of tumor progression. Elderly patient are often refuse radical cystectomy (RC) and urinary diversion, to keep their body image and quality of life. OBJECTIVES: To estimate the response rate of gemcitabine, paclitaxel, doxorubicin combined with radiotherapy aiming at bladder preservation in elderly patients =75 years old with recurrent high grade T1 urothelial carcinoma (UC). We conducted a prospective study to evaluate the multimodality treatment for bladder preservation in elderly patients. Overall survival, disease free survival, and quality of life were estimated and correlated with a matched arm of (RC). METHODS In a prospective study, we included 105 elderly patients with NMICB, 57 patients had high grade T1 tumor, 48 patients with high grade Ta, both TA and T1 were NMICB, patients were recurrent after complete course of intavesical BCG, patients asked for bladder preservation. The multimodality treatment arm was compared with matched arm of 60 patients treatment with RC. Follow up was up to 3 - 4years. Overall survival (OS) and disease free survival (DFS) was calculated using Kaplan-Mayer and Cox proportional hazards model and compared to a second arm of 30 patients with similar criteria that had RC. Inclusion criteria in both arms were non-metastatic NMICB, no prior chemotherapy, glomerular filtration rate <60?mL/min. Gemcitabine (900?mg/m(2)), paclitaxel (135?mg/m(2)), and doxorubicin (40?mg/m(2)) were administered on day 1 of each 14-day cycle. Pegfilgrastim was given with every cycle on either day 1 or day. low dose radiotherapy were given following chemotherapy. RESULTS Median age was 77 years (range 75-84). All patients had complete responses. Grade 3 and 4 nonhematologic toxicities were fatigue and mucositis (14% each). There were 12 episodes of neutropenic fever, no treatment-related deaths. Median overall survival was 28.5 months CONCLUSIONS Results of combination of gemcitabine, paclitaxel, and doxorubicin as first-line chemotherapy combination with radiotherapy for elderly patients with recurrent high grade Ta, T1 NMICB of UC in elderly patients =75 years old. Were compatible with RC. Bladder preservation with first line chemoradiothery would be considered as an alternative to RC in elderly patients as it offers better quality of life © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e174-e175 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Mohamed Wishahi More articles by this author Hossam Elganzoury More articles by this author Amr Elkhouly More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...