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By Alessandro Franciscon doctor
Brian C Baumann, Walter R Bosch, Amit Bahl, Alison J Birtle, Rodney H Breau, Amarnath Challapalli, Albert J Chang, Ananya Choudhury, Sia Daneshmand, Ali El-Gayed, Adam Feldman, Steven E Finkelstein, Thomas J Guzzo, Serena Hilman, Ashesh Jani, S Bruce Malkowicz, Constantine A Mantz, Viraj Master, Anita V Mitra, Vedang Murthy, Sima P Porten, Pierre M Richaud, Paul Sargos, Jason A Efstathiou, Libni J Eapen, John P Christodouleas
PURPOSE: To develop multi-institutional consensus clinical target volumes (CTVs) and organs at risk (OARs) for male and female bladder cancer patients undergoing adjuvant radiation therapy (RT) in clinical trials. METHODS AND MATERIALS: We convened a multidisciplinary group of bladder cancer specialists from 15 centers and 5 countries. Six radiation oncologists and 7 urologists participated in the development of the initial contours. The group proposed initial language for the CTVs and OARs, and each radiation oncologist contoured them on computed tomography scans of a male and female cystectomy patient with input from ≥1 urologist...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Matthew I Milowsky, R Bryan Rumble, Christopher M Booth, Timothy Gilligan, Libni J Eapen, Ralph J Hauke, Pat Boumansour, Cheryl T Lee
PURPOSE: To endorse the European Association of Urology guideline on muscle-invasive (MIBC) and metastatic bladder cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. METHODS: The guideline on MIBC and metastatic bladder cancer was reviewed for developmental rigor by methodologists. The ASCO Endorsement Panel then reviewed the content and recommendations...
June 1, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
N J Rene, F B Cury, L Souhami
The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion. Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer. Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy...
August 2009: Current Oncology
Ashish M Kamat, Richard J Sylvester, Andreas Böhle, Joan Palou, Donald L Lamm, Maurizio Brausi, Mark Soloway, Raj Persad, Roger Buckley, Marc Colombel, J Alfred Witjes
PURPOSE: To provide recommendations on appropriate clinical trial designs in non-muscle-invasive bladder cancer (NMIBC) based on current literature and expert consensus of the International Bladder Cancer Group. METHODS: We reviewed published trials, guidelines, meta-analyses, and reviews and provided recommendations on eligibility criteria, baseline evaluations, end points, study designs, comparators, clinically meaningful magnitude of effect, and sample size. RESULTS: NMIBC trials must be designed to provide the most clinically relevant data for the specific risk category of interest (low, intermediate, or high)...
June 1, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
W U Shipley, K A Winter, D S Kaufman, W R Lee, N M Heney, W R Tester, B J Donnelly, P M Venner, C A Perez, K J Murray, R S Doggett, L D True
PURPOSE: To assess the efficacy of neoadjuvant methotrexate, cisplatin, and vinblastine (MCV) chemotherapy in patients with muscle-invading bladder cancer treated with selective bladder preservation. PATIENTS AND METHODS: One hundred twenty-three eligible patients with tumor, node, metastasis system clinical stage T2 to T4aNXMO bladder cancer were randomized to receive (arm 1, n=61 ) two cycles of MCV before 39.6-Gy pelvic irradiation with concurrent cisplatin 100 mg/m2 for two courses 3 weeks apart...
November 1998: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Nicholas D James, Syed A Hussain, Emma Hall, Peter Jenkins, Jean Tremlett, Christine Rawlings, Malcolm Crundwell, Bruce Sizer, Thiagarajan Sreenivasan, Carey Hendron, Rebecca Lewis, Rachel Waters, Robert A Huddart
BACKGROUND: Radiotherapy is an alternative to cystectomy in patients with muscle-invasive bladder cancer. In other disease sites, synchronous chemoradiotherapy has been associated with increased local control and improved survival, as compared with radiotherapy alone. METHODS: In this multicenter, phase 3 trial, we randomly assigned 360 patients with muscle-invasive bladder cancer to undergo radiotherapy with or without synchronous chemotherapy. The regimen consisted of fluorouracil (500 mg per square meter of body-surface area per day) during fractions 1 to 5 and 16 to 20 of radiotherapy and mitomycin C (12 mg per square meter) on day 1...
April 19, 2012: New England Journal of Medicine
Raymond H Mak, Daniel Hunt, William U Shipley, Jason A Efstathiou, William J Tester, Michael P Hagan, Donald S Kaufman, Niall M Heney, Anthony L Zietman
PURPOSE: Multiple prospective Radiation Therapy Oncology Group (RTOG) protocols have evaluated bladder-preserving combined-modality therapy (CMT) for muscle-invasive bladder cancer (MIBC), reserving cystectomy for salvage treatment. We performed a pooled analysis of long-term outcomes in patients with MIBC enrolled across multiple studies. PATIENTS AND METHODS: Four hundred sixty-eight patients with MIBC were enrolled onto six RTOG bladder-preservation studies, including five phase II studies (RTOG 8802, 9506, 9706, 9906, and 0233) and one phase III study (RTOG 8903)...
December 1, 2014: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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