More than 385,000 new cases of bladder cancer were reported worldwide in 2008, according to a report on worldwide cancer incidence and mortality published by the International Agency for Research on Cancer. The standard treatment is surgery, but an alternative treatment is radiotherapy or chemoradiotherapy. In the 2000 issue ofEuropean Urology, Cooke and colleagues found that radiotherapy for muscle-invasive bladder cancer had up to a 50% rate of incomplete response or local recurrence.
This randomized, unblinded, phase 3 trial by James and colleagues assesses locoregional disease-free survival rates, overall survival rates, and adverse events in adults with muscle-invasive bladder cancer who receive radiotherapy with or without chemotherapy.
§ In adults with muscle-invasive bladder cancer, chemoradiotherapy vs radiotherapy results in a higher rate of locoregional disease-free survival at 2 years (67% vs 54%) and a lower relapse rate of invasive locoregional disease at 2 years (18% vs 32%).
§ In adults with muscle-invasive bladder cancer, the rates of overall survival and adverse events are not significantly different for those who receive chemoradiotherapy vs those who undergo radiotherapy.