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Neoadjuvant Chemotherapy Case Study

Satisfactory Essays
Patient and methods

Between January 2010 and July 2014, forty eight patients diagnosed as muscle invasive bladder cancer T2b-T4aN0M0 and not amenable or refuse radical cystectomy are enrolled in this prospective study. Eligibility criteria included, ECOG (Eastern Cooperative Oncology Group) performance status 0-2, haemoglobin> 10 gm/dl, white blood cells(WBC) > 3000/mm3, platelets > 100,000/mm3 ,creatinine clearance < 60 ml/min .Patients who received chemotherapy, radiotherapy or had prior history of malignancy were excluded from study. An approval of local ethics committee and an informed consent from all patients were obtained.
Neoadjuvant chemotherapy
All patients underwent routine laboratory and radiological work up for staging and assessment of performance status. Maximal TURBT was carried out for all patients followed by neoadjuvant chemotherapy within 1 week. Patients received carboplatin AUC on day 1 followed gemcitabine 1,000 mg/m2 on day 1 and 8 repeated every
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Late Radiation Morbidity Scoring Criteria were used to score toxicity according to The Radiation Therapy Oncology Group (RTOG)[8]. Toxicities were assessed in regular clinic visit every 2 weeks through treatment periodand monthly after ending of treatment
2-Outcome was evaluated at follow up cystoscopy and tumor site biopsy done after completion of all 6 cycles of radiotherapy .Response assessment according to response evaluation criteria in solid tumors (RECIST). Complete response (CR) was considered if complete regression of all evidence of tumors was achived while Partial response (PR)if there is an estimated decrease in tumors size of 50% or more. Stable disease (SD) was reporeted if less than 50%in tumor size or less than 25% of pretreatment tumor size was achievedwhile Progressive disease (PD) if there is more than 25% increase in pretreatment tumor size[9].
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