ADJUVANT RADIOTHERAPY WITH AND WITHOUT CONCURRENT CHEMOTHERAPY FOR LOCALLY ADVANCED TRANSITIONAL CELL CARCINOMA OF THE RENAL PELVIS AND URETER

No AccessJournal of UrologyAdult Urology: Oncology: Renal/Upper Tract/Bladder1 Oct 2004ADJUVANT RADIOTHERAPY WITH AND WITHOUT CONCURRENT CHEMOTHERAPY FOR LOCALLY ADVANCED TRANSITIONAL CELL CARCINOMA OF THE RENAL PELVIS AND URETER BRIAN CZITO, ANTHONY ZIETMAN, DONALD KAUFMAN, URI SKOWRONSKI, and WILLIAM SHIPLEY BRIAN CZITOBRIAN CZITO More articles by this author , ANTHONY ZIETMANANTHONY ZIETMAN More articles by this author , DONALD KAUFMANDONALD KAUFMAN More articles by this author , URI SKOWRONSKIURI SKOWRONSKI More articles by this author , and WILLIAM SHIPLEYWILLIAM SHIPLEY More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000137910.38441.8aAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Transitional cell carcinoma of the upper urinary tract is a relatively uncommon malignancy. The role of adjuvant radiation therapy and chemotherapy is not well defined. We retrospectively reviewed the records of 31 patients who underwent surgery followed by adjuvant radiotherapy with or without concurrent chemotherapy to determine overall outcome as well as impact of concurrent chemotherapy administration. Materials and Methods: Between 1970 and 1997, 31 patients with nonmetastatic transitional cell carcinoma of the upper urinary tract (renal pelvis in 13, ureter in 15, and renal pelvis and ureter in 3) were treated with radiotherapy following attempted curative resection. Most patients (28 of 31) had T3/4 and/or N+ disease. The median radiation dose was 46.9 Gy. Nine pati-ents received methotrexate, cisplatin and vinblastine chemotherapy for 2 to 4 cycles, followed by concurrent cisplatin with radiation. Results: Median followup was 2.6 years in all patients and 8.5 years in survivors. Median survival in all patients was 2.4 years. Of the patients 16 (52%) experienced disease relapse, including 9 (29%) with distant metastases alone. Seven patients (23%) experienced locoregional failure with distant metastases developing in all except 1 within 8 months of locoregional failure diagnosis. Five-year actuarial overall survival, disease specific survival, locoregional control and metastasis-free survival rates were 39%, 52%, 67% and 48%, respectively. On univariate analysis patients had improved 5-year actuarial overall and disease specific survival with the administration of concurrent chemotherapy (27% vs 67%, p = 0.01 and 41% vs 76%, p = 0.06, respectively). Conclusions: Our series suggests that the addition of concurrent cisplatin to adjuvant radiotherapy improves the ultimate outcome in patients with resected, locally advanced upper tract urothelial malignancies. This regimen should be considered in patients with T3/4 and/or node positive upper tract transitional cell carcinoma. 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Google Scholar From the Departments of Radiation Oncology (BC, AZ, US, WS) and Medical Oncology (DK), Massachusetts General Hospital, Boston, Massachusetts, and Department of Radiation Oncology (BC), Duke University Medical Center, Durham, North Carolina© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByWu C, Pang S, Chen C, Chuang C, Chen Y and Lin P (2018) The Impact Factors on Prognosis of Patients With pT3 Upper Urinary Tract Transitional Cell CarcinomaJournal of Urology, VOL. 178, NO. 2, (446-450), Online publication date: 1-Aug-2007.KIKUCHI E, HORIGUCHI Y, NAKASHIMA J, HATAKEYAMA N, MATSUMOTO M, NISHIYAMA T and MURAI M (2018) LYMPHOVASCULAR INVASION INDEPENDENTLY PREDICTS INCREASED DISEASE SPECIFIC SURVIVAL IN PATIENTS WITH TRANSITIONAL CELL CARCINOMA OF THE UPPER URINARY TRACTJournal of Urology, VOL. 174, NO. 6, (2120-2124), Online publication date: 1-Dec-2005. Volume 172Issue 4 Part 1October 2004Page: 1271-1275 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordscarcinomaureterdrug therapytransitional cellkidneyradiotherapyMetricsAuthor Information BRIAN CZITO More articles by this author ANTHONY ZIETMAN More articles by this author DONALD KAUFMAN More articles by this author URI SKOWRONSKI More articles by this author WILLIAM SHIPLEY More articles by this author Expand All Advertisement PDF DownloadLoading ...