Trimodal therapy in muscle-invasive bladder cancer. Experience of 13 years.

Abstract

Objective: Thirteen years of experience in the Dr. Enrique M. Gutiérrez Radiotherapy Service at CMDLT in the treatment of non-metastatic muscle-invasive bladder cancer (MIBC) using a trimodal therapy strategy. (TMT) Methods: Observational, descriptive, single-institution study. Patients diagnosed with muscle-invasive bladder cancer treated with TMT between 2006 and 2019. Results: Median age was 75 years old. 31 patients with stage II and IIIA MIBC. All patients underwent transurethral resection (TUR) of the tumor lesion. 61.3% of patients received chemotherapy prior to concurrent RT and gemcitabine-based platinum chemotherapy. 38.7% of patients who underwent TUR only received concurrent platinum-based RT-CT. The 2-year overall survival was 69%, and the 5-year overall survival was 33%. Local recurrence-free survival was 92% at 2 years and 79% at 5 years. The 2-year and 5-year distant recurrence-free survival rates were 88.1% and 56.6%, respectively. The most frequent acute complications were grade II urinary and gastrointestinal events. Conclusions: Trimodal therapy is an appropriate alternative for patients with MIBC. Oncologic outcomes are similar to those achieved with RC, with the benefit of bladder preservation and improved quality of life; it should be considered a standard treatment option in selected patients.