Bladder Cancer
Conditions
Keywords
multidisciplinary; bladder cancer; bladder-preservation
Brief summary
A multidisciplinary approach has led to the development of bladder-preservation therapy using maximal transurethral resection followed by radiotherapy with concomitant radio-sensitizing chemotherapy for muscle-invasive bladder cancer.
Detailed description
Multidisciplinary management improves complex treatment decision making in cancer care, but its impact for bladder cancer has not been documented. Although radical cystectomy (RC) has long been the standard of care for the management of muscle-invasive bladder cancer (MIBC), a multidisciplinary approach has led to the development of bladder-preservation therapy using maximal transurethral resection (TURBt) followed by radiotherapy with concomitant radio-sensitizing chemotherapy for MIBC. There are no randomized-controlled data comparing radical cystectomy with multidisciplinary bladder-preservation therapy (MBPT) available for comparison. However, observational data continues to support the use of MBPT as an acceptable alternative for patients with MIBC who wish to preserve their bladder or are not candidates for cystectomy because it may result in equivalent disease outcomes in select patients and offers the benefit of maintaining a functioning urinary system with subsequent improvements in quality of life. But there are also lots of issues need to be studied, such as the patient selection, approaches for completeness of TURBt, choices of radio-sensitizing chemotherapy, accuracy of radiotherapy and so on. In this study, the investigators plan to prospectively recruit 80 MIBC patients, who don't want to receive RC or are not candidates for RC, treated with MBPT from Nov 2018 to Dec 2020 in Peking University Third Hospital. The investigators will collect, compare and analyze their clinic-pathological data before and after MBPT, in order to confirm the safety and efficacy of MBPT for MIBC in China. At the same time, the investigators want to find out the patients who are not suitable for MBPT and the approach which can improve the efficacy of MBPT, as a result, the investigators intend to make a standard MBPT approach for Chinese MIBC patients.
Interventions
PROCEDUREmultidisciplinary bladder-preservation therapy
Maximal transurethral resection followed by radiotherapy with concomitant radio-sensitizing chemotherapy
Sponsors
Peking University Third Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
In this study, the investigators plan to prospectively recruit 80 muscle-invasive bladder cancer patients, who don't want to receive radical cystectomy or are not candidates for radical cystectomy, treated with multidisciplinary bladder-preservation therapy from Nov 2018 to Dec 2020 in Peking University Third Hospital.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Bladder urothelial carcinoma 2. Clinical stage: T2-T4, non-metastasis 3. Eastern Cooperative Oncology Group score (ECOG)≤ 1, Karnofsky performance score≥ 70 4. Patients don't want to receive RC or are not candidates for RC 5. Normal bladder function
Exclusion criteria
1. History of abdominal and pelvic radiotherapy 2. History of other malignant tumor 3. Pregnant or lactating patients 4. Severe comorbidity: cardiac infarction, arrhythmia, heart failure, et al
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Complete response rate | 6-8 weeks after chemoradiation | Response to MBPT depending on cystoscopy, TURBt, or urinary cytology |
| Disease specific survival (DSS) time | From date of treatment initiation until the date of death due to bladder cancer, assessed up to 60 months. | Events were defined as death attributable to bladder cancer. The time to DSS was the interval between treatment initiation and death due to bladder cancer, or the most recent follow-up if no event occurred. |
| Overall survival (OS) time | From date of treatment initiation until the date of death due to any cause, assessed up to 60 months. | Events were defined as death due to any cause. The time to OS was the interval between treatment initiation and death, or the most recent follow-up if no event occurred. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life score 1 | 6-8 weeks after chemoradiation | Assessed by EORTC Quality of life questionaire (QLQ)-30 |
| Quality of life score 2 | 6-8 weeks after chemoradiation | Assessed by EORTC QLQ-Bladder Cancer 30 |
Countries
China
Contacts
Primary ContactHai Bi, MD
Outcome results
None listed