Chemo Plus Radiation Prevents Bladder Cancer Return
Study Shows Benefits of Adding Chemotherapy to Radiation Therapy
Nov. 2, 2010 (San Diego) -- The addition of chemotherapy to radiation for the treatment of bladder cancer allowed more people to remain disease free than if they received radiation alone, British researchers report.
"By adding chemotherapy to radiation therapy, 82% of [living] patients were free of invasive bladder cancer -- the most worrisome form of the disease -- two years after treatment," Nicholas James, MD, professor of clinical oncology at the University of Birmingham, England, tells WebMD.
"This compared to 68% of those who received radiation alone."
That corresponds to cutting the risk of an invasive recurrence by nearly half, James says.
"In the majority of cases, people were able to preserve normal urinary function," he says. "For patients, that's hugely important."
The findings come a day after former basketball star Maurice Lucas died from bladder cancer.
Invasive Bladder Cancer
A recurrence of invasive bladder cancer occurs in the muscle of the bladder wall, James says. "It's what kills you."
In contrast, a recurrence of superficial bladder cancer occurs in the lining of the bladder. "The surgeon can just scoop it out. It's not life-threatening," James says.
In the study, treatment with chemotherapy and radiation allowed 67% of patients who were still alive to be free of all disease in their bladders -- including superficial cancer -- two years after treatment, compared with 54% of people who received radiation alone.
The study involved 360 people with invasive bladder cancer. About half got radiation alone and half got chemo plus radiation.
James says that the study involved older people than in most studies. Their average age was about 73, and 15% were over 80.
The study, which James says is the largest of its kind, was presented here at the 52nd annual meeting of the American Society for Radiation Oncology (ASTRO).
Side Effects of Treatment
During treatment, there was an increase in serious side effects such as an extreme drop in the number of infection-fighting white blood cells in the group receiving chemotherapy: 36% vs. 28% in the group getting radiation alone, James says. But the difference was so small, it could have been due to chance, he says.
Nearly all patients in both groups -- 80% to 90% of those who got radiation alone and 85% to 95% of those who also got chemo -- reported some side effects such as nausea or fatigue.
After treatment, the rate of side effects was the same in both groups. "Seventy percent of patients reported no side effects at all after three months," he says.
By two years after treatment, about 60% of people in both groups were still alive. If the study was larger, "we might see a difference in survival rates. This study was not powered to show a difference," says Phillip Devlin, MD, a radiation oncologist at Harvard Medical School who was not involved with the study.