浸潤性膀胱癌に対する温熱化学放射線治療による膀胱温存療法の初期経験

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  • Initial Experience of Bladder Preservation Therapy Using Chemoradiotherapy with Regional Hyperthermia for Muscle-invasive Bladder Cancer

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Recently, organ-preserving regimens using predominantly multiple-modality therapy, consisting of endoscopic transurethral resection followed by irradiation with concurrent chemotherapy, are emerging as viable alternatives for muscle-invasive bladder cancer, although radical cystectomy has been the standard treatment. Three cases with muscle-invasive bladder cancer (5-7 cm in size), two of T2N1M0 and one of T2N0M0, underwent bladder preservation therapy with regional hyperthermia for improvement of the local effect. A total dose of 66-70Gy in the conventional methods, chemotherapy composed of methotrexate, doxorubicin, cisplatin and/or vinblastine, and 3 to 12 sessions of hyperthermia during radiotherapy were delivered. All three cases showed complete response without any local recurrence or distant metastasis in follow-ups. Toxicity during the treatment was acceptable, and late toxicity was not recognized. Bladder preservation therapy adding regional hyperthermia is potentially useful for improving the treatment results for muscle-invasive bladder cancer of large tumor size.

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