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    Phase I study of conformal radiotherapy with concurrent gemcitabine in locally advanced bladder cancer.

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    Authors
    Sangar, Vijay K
    McBain, Catherine A
    Lyons, Jeanette
    Ramani, Vijay A C
    Logue, John P
    Wylie, James P
    Clarke, Noel W
    Cowan, Richard A
    Affiliation
    Department of Urology, Christie Hospital NHS Trust, Manchester M20 4XB, UK.
    Issue Date
    2005-02-01
    
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    Abstract
    PURPOSE: A prospective phase I trial was conducted to determine the maximal tolerated dose of gemcitabine given once weekly during hypofractionated conformal radiotherapy to patients with locally advanced transitional cell carcinoma of the bladder. Eight male patients, median age 69 years, with Stage T2 (n = 4) or T3 (n = 4) N0M0, were enrolled in cohorts of 3. Treatment comprised conformal radiotherapy (52.5 Gy in 20 fractions) within 4 weeks, with concurrent gemcitabine once weekly for four cycles. The weekly gemcitabine dose was escalated from 100 mg/m(2) in increments of 50 mg/m(2) per cohort. Dose-limiting toxicity was defined as any acute Radiation Therapy Oncology Group (RTOG) toxicity Grade 3 or greater arising in >1 of 3 patients in each cohort. Tumor response was assessed cystoscopically and radiologically at 3 months. RESULTS: All 8 patients completed radiotherapy, and 6 of 8 completed chemoradiotherapy. No acute toxicity greater than RTOG Grade 1 was seen with gemcitabine at 100 mg/m(2). Dose-limiting toxicity was observed at 150 mg/m(2) with Grade 3 toxicity seen in 2 of 2 patients (one bladder, one bowel). An additional 3 patients received 100 mg/m(2) with minimal toxicity. No hematologic toxicity was encountered. A complete response was seen in 7 (87.5%) of 8 patients, all of whom were disease free at a median follow-up of 19.5 months (range, 14-23 months). No late toxicity (greater than RTOG Grade 0) has been observed. CONCLUSION: The maximal tolerated dose for gemcitabine given once weekly with concurrent hypofractionated conformal bladder radiotherapy was 150 mg/m(2), with a maximal recommended dose of 100 mg/m(2). This dose regimen has now entered Phase II clinical trials.
    Citation
    Phase I study of conformal radiotherapy with concurrent gemcitabine in locally advanced bladder cancer. 2005, 61 (2):420-5 Int. J. Radiat. Oncol. Biol. Phys.
    Journal
    International Journal of Radiation Oncology, Biology, Physics
    URI
    http://hdl.handle.net/10541/76802
    DOI
    10.1016/j.ijrobp.2004.05.074
    PubMed ID
    15667962
    Type
    Article
    Language
    en
    ISSN
    0360-3016
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijrobp.2004.05.074
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