Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study
Background Transurethral resection of bladder tumor (TUR-BT) followed by chemoradiation (CRT) is a valid treatment option for patients with muscle-invasive bladder cancer (MIBC). This study aimed to investigate the efficacy of a tetramodal approach with additional regional hyperthermia (RHT).Methods...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-12-01
|
| Series: | International Journal of Hyperthermia |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2022.2109763 |
| _version_ | 1811340220611690496 |
|---|---|
| author | Oliver Riesterer Adela Ademaj Emsad Puric Brigitte Eberle Marcus Beck Silvia Gomez Dietmar Marder Eva Oberacker Susanne Rogers Roger A. Hälg Thomas Kern Sonja Schwenne Jürgen Stein Emanuel Stutz Olaf Timm Sebastian Zschaeck Mathias S. Weyland Paraskevi D. Veltsista Stephen Wyler Peter Wust Stephan Scheidegger Stephan Bodis Pirus Ghadjar |
| author_facet | Oliver Riesterer Adela Ademaj Emsad Puric Brigitte Eberle Marcus Beck Silvia Gomez Dietmar Marder Eva Oberacker Susanne Rogers Roger A. Hälg Thomas Kern Sonja Schwenne Jürgen Stein Emanuel Stutz Olaf Timm Sebastian Zschaeck Mathias S. Weyland Paraskevi D. Veltsista Stephen Wyler Peter Wust Stephan Scheidegger Stephan Bodis Pirus Ghadjar |
| author_sort | Oliver Riesterer |
| collection | DOAJ |
| description | Background Transurethral resection of bladder tumor (TUR-BT) followed by chemoradiation (CRT) is a valid treatment option for patients with muscle-invasive bladder cancer (MIBC). This study aimed to investigate the efficacy of a tetramodal approach with additional regional hyperthermia (RHT).Methods Patients with stages T2–4 MIBC were recruited at two institutions. Treatment consisted of TUR-BT followed by radiotherapy at doses of 57–58.2 Gy with concurrent weekly platinum-based chemotherapy and weekly deep RHT (41–43 °C, 60 min) within two hours of radiotherapy. The primary endpoint was a complete response six weeks after the end of treatment. Further endpoints were cystectomy-free rate, progression-free survival (PFS), local recurrence-free survival (LRFS), overall survival (OS) and toxicity. Quality of life (QoL) was assessed at follow-up using the EORTC-QLQ-C30 and QLQ-BM30 questionnaires. Due to slow accrual, an interim analysis was performed after the first stage of the two-stage design.Results Altogether 27 patients were included in the first stage, of these 21 patients with a median age of 73 years were assessable. The complete response rate of evaluable patients six weeks after therapy was 93%. The 2-year cystectomy-free rate, PFS, LRFS and OS rates were 95%, 76%, 81% and 86%, respectively. Tetramodal treatment was well tolerated with acute and late G3–4 toxicities of 10% and 13%, respectively, and a tendency to improve symptom-related quality of life (QoL) one year after therapy.Conclusion Tetramodal therapy of T2–T4 MIBC is promising with excellent local response, moderate toxicity and good QoL. This study deserves continuation into the second stage. |
| first_indexed | 2024-04-13T18:38:46Z |
| format | Article |
| id | doaj.art-3124c2542f004dd49d96ffbea0bbc532 |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-04-13T18:38:46Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-3124c2542f004dd49d96ffbea0bbc5322022-12-22T02:34:48ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572022-12-013911078108710.1080/02656736.2022.2109763Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB studyOliver Riesterer0Adela Ademaj1Emsad Puric2Brigitte Eberle3Marcus Beck4Silvia Gomez5Dietmar Marder6Eva Oberacker7Susanne Rogers8Roger A. Hälg9Thomas Kern10Sonja Schwenne11Jürgen Stein12Emanuel Stutz13Olaf Timm14Sebastian Zschaeck15Mathias S. Weyland16Paraskevi D. Veltsista17Stephen Wyler18Peter Wust19Stephan Scheidegger20Stephan Bodis21Pirus Ghadjar22Centre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandDepartment of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandDepartment of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandDepartment of Urology, Bundeswehrkrankenhaus Berlin, Berlin, GermanyCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandDepartment of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyZHAW School of Engineering, Zurich University of Applied Science, Zurich, SwitzerlandDepartment of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Urology, Cantonal Hospital Aarau, Aarau, SwitzerlandDepartment of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyZHAW School of Engineering, Zurich University of Applied Science, Zurich, SwitzerlandCentre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, SwitzerlandDepartment of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyBackground Transurethral resection of bladder tumor (TUR-BT) followed by chemoradiation (CRT) is a valid treatment option for patients with muscle-invasive bladder cancer (MIBC). This study aimed to investigate the efficacy of a tetramodal approach with additional regional hyperthermia (RHT).Methods Patients with stages T2–4 MIBC were recruited at two institutions. Treatment consisted of TUR-BT followed by radiotherapy at doses of 57–58.2 Gy with concurrent weekly platinum-based chemotherapy and weekly deep RHT (41–43 °C, 60 min) within two hours of radiotherapy. The primary endpoint was a complete response six weeks after the end of treatment. Further endpoints were cystectomy-free rate, progression-free survival (PFS), local recurrence-free survival (LRFS), overall survival (OS) and toxicity. Quality of life (QoL) was assessed at follow-up using the EORTC-QLQ-C30 and QLQ-BM30 questionnaires. Due to slow accrual, an interim analysis was performed after the first stage of the two-stage design.Results Altogether 27 patients were included in the first stage, of these 21 patients with a median age of 73 years were assessable. The complete response rate of evaluable patients six weeks after therapy was 93%. The 2-year cystectomy-free rate, PFS, LRFS and OS rates were 95%, 76%, 81% and 86%, respectively. Tetramodal treatment was well tolerated with acute and late G3–4 toxicities of 10% and 13%, respectively, and a tendency to improve symptom-related quality of life (QoL) one year after therapy.Conclusion Tetramodal therapy of T2–T4 MIBC is promising with excellent local response, moderate toxicity and good QoL. This study deserves continuation into the second stage.https://www.tandfonline.com/doi/10.1080/02656736.2022.2109763Bladder cancertetramodal therapyregional hyperthermiaradiochemotherapybladder preservation |
| spellingShingle | Oliver Riesterer Adela Ademaj Emsad Puric Brigitte Eberle Marcus Beck Silvia Gomez Dietmar Marder Eva Oberacker Susanne Rogers Roger A. Hälg Thomas Kern Sonja Schwenne Jürgen Stein Emanuel Stutz Olaf Timm Sebastian Zschaeck Mathias S. Weyland Paraskevi D. Veltsista Stephen Wyler Peter Wust Stephan Scheidegger Stephan Bodis Pirus Ghadjar Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study International Journal of Hyperthermia Bladder cancer tetramodal therapy regional hyperthermia radiochemotherapy bladder preservation |
| title | Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study |
| title_full | Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study |
| title_fullStr | Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study |
| title_full_unstemmed | Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study |
| title_short | Tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle-invasive bladder cancer: early results of a multicenter phase IIB study |
| title_sort | tetramodal therapy with transurethral resection followed by chemoradiation in combination with hyperthermia for muscle invasive bladder cancer early results of a multicenter phase iib study |
| topic | Bladder cancer tetramodal therapy regional hyperthermia radiochemotherapy bladder preservation |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2022.2109763 |
| work_keys_str_mv | AT oliverriesterer tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT adelaademaj tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT emsadpuric tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT brigitteeberle tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT marcusbeck tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT silviagomez tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT dietmarmarder tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT evaoberacker tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT susannerogers tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT rogerahalg tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT thomaskern tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT sonjaschwenne tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT jurgenstein tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT emanuelstutz tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT olaftimm tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT sebastianzschaeck tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT mathiassweyland tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT paraskevidveltsista tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT stephenwyler tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT peterwust tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT stephanscheidegger tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT stephanbodis tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy AT pirusghadjar tetramodaltherapywithtransurethralresectionfollowedbychemoradiationincombinationwithhyperthermiaformuscleinvasivebladdercancerearlyresultsofamulticenterphaseiibstudy |