1. Vinorelbine in bladder-preserving multimodality treatment for muscle-invasive bladder cancer—a valid option for cisplatin-unfit patients?
- Author
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Arnold, C. R., Lindner, A. K., Schachtner, G., Tulchiner, G., Tulchiner, N., Mangesius, J., Maffei, M., Horninger, W., Kouvaiou, O., Lukas, P., Ganswindt, U., Pichler, R., and Skvortsov, S.
- Subjects
BLADDER tumors ,CONFIDENCE intervals ,RETROSPECTIVE studies ,CHEMORADIOTHERAPY ,CANCER patients ,PRESERVATION of organs, tissues, etc. ,CISPLATIN ,DESCRIPTIVE statistics ,COMBINED modality therapy ,VINORELBINE ,ODDS ratio - Abstract
Purpose: Treatment of muscle-invasive bladder cancer (MIBC) remains challenging, especially for elderly and/or comorbid patients. Patients who are unfit for or refuse surgery should receive bladder-preserving multimodality treatment (BPMT), consisting of transurethral resection of the bladder tumor (TURB) followed by combined chemoradiotherapy (CRT). We aimed to investigate the effectiveness of vinorelbine, a chemotherapeutic agent not routinely used for MIBC, in patients referred to CRT who are unfit for standard chemotherapy and would thus rely solely on radiotherapy (RT). Methods: We retrospectively analyzed 52 consecutive patients with MIBC who received standard CRT with cisplatin (n = 14), CRT with vinorelbine (n = 26), or RT alone (n = 12). Primary endpoints were median overall survival (OS) and median cancer-specific survival (CSS). Secondary endpoints were median local control (LC), median distant control (DC), and OS, CSS, LC, and DC after 1, 2, and 3 years, respectively. Results: Median OS and CSS were significantly higher for patients who received vinorelbine as compared to RT alone (OS 8 vs. 22 months, p = 0.003; CSS 11 months vs. not reached, p = 0.001). Median LC and DC did not differ significantly between groups. Vinorelbine was well tolerated with no reported side effects >grade II. Conclusion: Our results suggest that CRT with vinorelbine is well tolerated and superior to RT alone in terms of OS and CSS. Therefore, this treatment regime might constitute a new treatment option for patients with MIBC who are unfit for or refuse surgery or standard chemotherapy. This study encourages a randomized controlled trial to compare this new regime to current standard therapies. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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