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Decades of experience now exist to support the use of chemoradiotherapy in the treatment of muscle-invasive bladder cancer. Chemoradiotherapy for T1 tumors that recur following bacillus Calmette-Guérin therapy is promising and provides an important curative alternative for those unable or unwilling to undergo radical cystectomy.
Drs. Fernando and Sandler have
written a thorough review that
has documented why a bladder-
conserving therapy can now be
more widely accepted treatment for patients
with muscle-invading bladder
cancer. They have shown that this treatment
approach, while selective, does
have a high likelihood of eradicating
the primary tumor, preserving good organ
function, and not compromising
patient survival. These successful approaches
have evolved over the past 25
years following initial reports of the
effectiveness of cisplatin against transitional
cell carcinoma and then reports
of added efficacy when cisplatin
is given concurrently with radiation.
Drs. Fernando and Sandler have
written a thorough review that
has documented why a bladder-
conserving therapy can now be
more widely accepted treatment for patients
with muscle-invading bladder
cancer. They have shown that this treatment
approach, while selective, does
have a high likelihood of eradicating
the primary tumor, preserving good organ
function, and not compromising
patient survival. These successful approaches
have evolved over the past 25
years following initial reports of the
effectiveness of cisplatin against transitional
cell carcinoma and then reports
of added efficacy when cisplatin
is given concurrently with radiation.
In this two-part article, Krieg and Hoffman review the management of patients with cancer of the penis and those with cancer of the urethra, respectively. Both of these cancers are uncommon, and, when they present as small, early, circumscribed lesions, both can be cured (with organ preservation) by radiation therapy. Also following organ preservation by radiation therapy, these patients must continue to be followed closely because 25% to 35% will develop a local recurrence and can be cured by prompt salvage surgery.
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