NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE

Objective: To determine the efficacy of trimodality therapy in patients with muscle invasive carcinoma of the bladder with deranged renal profile. Study Design: Quasi-experimental study. Place and Duration of Study: Oncology Department, Combined Military Hospital Rawalpindi over 14 months,...

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Autores principales: Muhammad Adnan Zeb, Muhammad Sohaib Nadeem, Abdus Samad Saeed, Qurat ul Ain, Ujala Ali
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Lenguaje:EN
Publicado: Army Medical College Rawalpindi 2018
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Acceso en línea:https://doaj.org/article/2fe5b81aeda24a7181d0235a13b507da
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spelling oai:doaj.org-article:2fe5b81aeda24a7181d0235a13b507da2021-11-26T03:26:56ZNON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE0030-96482411-8842https://doaj.org/article/2fe5b81aeda24a7181d0235a13b507da2018-12-01T00:00:00Zhttps://www.pafmj.org/index.php/PAFMJ/article/view/2562/2100https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To determine the efficacy of trimodality therapy in patients with muscle invasive carcinoma of the bladder with deranged renal profile. Study Design: Quasi-experimental study. Place and Duration of Study: Oncology Department, Combined Military Hospital Rawalpindi over 14 months, from Sep 2015 to Nov 2016. Patients and Methods: Forty patients (n=40) having histopathologically confirmed (urothelial) urinary bladder cancer, clinical stage II or III, aged 18 to 80 years, with Eastern Cooperative Oncology Group (ECOG) perfor-mance status ≤2 and having deranged renal functions were included in this study. After maximal transurethral resection of bladder tumour (TURBT), they received 4 courses of chemotherapy with mitomycin and 5 fluorou-racil, followed by concurrent chemoradiation using same chemotherapy received 50 Grays in 20 fractions. Response was assessed using RECIST criteria. Results: Efficacy; defined in terms of complete and partial response, was observed in 85% (n=34) of patients. Treatment efficacy was better in males as compared to females (90.6% vs. 62.55: p<0.05). Patients with better ECOG-PS (0-1) and early stage (2) responded well to treatment while response was almost same in different age groups, (p>0.05 in all cases). Thirty-seven patients were able to complete the full study protocol, 2 had severe mucositis and hand-foot syndrome while one patient died after septicaemia. Conclusion: Trimodality treatment with TURBT, chemotherapy and chemo-radiation is a feasible option for bladder preservation in muscle invasive bladder cancer patients with compromised renal functions if we use 5-fluorouracil and mitomycin chemotherapy.Muhammad Adnan ZebMuhammad Sohaib NadeemAbdus Samad SaeedQurat ul AinUjala AliArmy Medical College Rawalpindiarticleconcurrent chemo-radiation therapyderanged renal profilemuscle invasive bladder cancerorgan preservationMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 68, Iss 6, Pp 1636-1641 (2018)
institution DOAJ
collection DOAJ
language EN
topic concurrent chemo-radiation therapy
deranged renal profile
muscle invasive bladder cancer
organ preservation
Medicine
R
Medicine (General)
R5-920
spellingShingle concurrent chemo-radiation therapy
deranged renal profile
muscle invasive bladder cancer
organ preservation
Medicine
R
Medicine (General)
R5-920
Muhammad Adnan Zeb
Muhammad Sohaib Nadeem
Abdus Samad Saeed
Qurat ul Ain
Ujala Ali
NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE
description Objective: To determine the efficacy of trimodality therapy in patients with muscle invasive carcinoma of the bladder with deranged renal profile. Study Design: Quasi-experimental study. Place and Duration of Study: Oncology Department, Combined Military Hospital Rawalpindi over 14 months, from Sep 2015 to Nov 2016. Patients and Methods: Forty patients (n=40) having histopathologically confirmed (urothelial) urinary bladder cancer, clinical stage II or III, aged 18 to 80 years, with Eastern Cooperative Oncology Group (ECOG) perfor-mance status ≤2 and having deranged renal functions were included in this study. After maximal transurethral resection of bladder tumour (TURBT), they received 4 courses of chemotherapy with mitomycin and 5 fluorou-racil, followed by concurrent chemoradiation using same chemotherapy received 50 Grays in 20 fractions. Response was assessed using RECIST criteria. Results: Efficacy; defined in terms of complete and partial response, was observed in 85% (n=34) of patients. Treatment efficacy was better in males as compared to females (90.6% vs. 62.55: p<0.05). Patients with better ECOG-PS (0-1) and early stage (2) responded well to treatment while response was almost same in different age groups, (p>0.05 in all cases). Thirty-seven patients were able to complete the full study protocol, 2 had severe mucositis and hand-foot syndrome while one patient died after septicaemia. Conclusion: Trimodality treatment with TURBT, chemotherapy and chemo-radiation is a feasible option for bladder preservation in muscle invasive bladder cancer patients with compromised renal functions if we use 5-fluorouracil and mitomycin chemotherapy.
format article
author Muhammad Adnan Zeb
Muhammad Sohaib Nadeem
Abdus Samad Saeed
Qurat ul Ain
Ujala Ali
author_facet Muhammad Adnan Zeb
Muhammad Sohaib Nadeem
Abdus Samad Saeed
Qurat ul Ain
Ujala Ali
author_sort Muhammad Adnan Zeb
title NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE
title_short NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE
title_full NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE
title_fullStr NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE
title_full_unstemmed NON-INVASIVE TREATMENT OF MUSCLE INVASIVE BLADDER CANCER IN PATIENTS WITH DERANGED RENAL PROFILE
title_sort non-invasive treatment of muscle invasive bladder cancer in patients with deranged renal profile
publisher Army Medical College Rawalpindi
publishDate 2018
url https://doaj.org/article/2fe5b81aeda24a7181d0235a13b507da
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AT abdussamadsaeed noninvasivetreatmentofmuscleinvasivebladdercancerinpatientswithderangedrenalprofile
AT quratulain noninvasivetreatmentofmuscleinvasivebladdercancerinpatientswithderangedrenalprofile
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