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근침윤성 방광암에서 화학방사선 병용을 통한 방광보존치료

Other Titles
 Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer : A Five-Year Follow-up 
Authors
 조재호  ;  임지훈  ;  성진실  ;  표홍렬  ;  금웅섭  ;  서창옥  ;  홍성준 
Citation
 Journal of the Korean Society for Therapeutic Radiology and Oncology (대한방사선종양학회지), Vol.19(4) : 359-368, 2001 
Journal Title
 Journal of the Korean Society for Therapeutic Radiology and Oncology (대한방사선종양학회지) 
ISSN
 1229-8719 
Issue Date
2001
Keywords
Invasive bladder cancer ; Bladder preservation ; Combined chemoradiotherapy ; Transurethral resection of bladder
Abstract
Purpose: To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer. Methods and materials: From 1991 Jan. through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated with induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of all patients was 70 months. Results: Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was 67.3%. Complete remission rate was 80% (20/25). Sixty-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion: Combined modality therapy with TURB, chemotherapy, and radiation has a 67.3% overall 5 year survival rate. This results is similar to cystectomy-based studies for patients of similar clinical stages. Sixty-three percent of long term survivors preserved their bladders.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Suh, Chang Ok(서창옥)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142483
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