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dc.contributor.authorSangar, Vijay K
dc.contributor.authorMcBain, Catherine A
dc.contributor.authorLyons, Jeanette
dc.contributor.authorRamani, Vijay A C
dc.contributor.authorLogue, John P
dc.contributor.authorWylie, James P
dc.contributor.authorClarke, Noel W
dc.contributor.authorCowan, Richard A
dc.date.accessioned2009-08-10T10:22:47Z
dc.date.available2009-08-10T10:22:47Z
dc.date.issued2005-02-01
dc.identifier.citationPhase I study of conformal radiotherapy with concurrent gemcitabine in locally advanced bladder cancer. 2005, 61 (2):420-5 Int. J. Radiat. Oncol. Biol. Phys.en
dc.identifier.issn0360-3016
dc.identifier.pmid15667962
dc.identifier.doi10.1016/j.ijrobp.2004.05.074
dc.identifier.urihttp://hdl.handle.net/10541/76802
dc.description.abstractPURPOSE: 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.
dc.language.isoenen
dc.subjectUrinary Bladder Canceren
dc.subject.meshAged
dc.subject.meshAntimetabolites, Antineoplastic
dc.subject.meshCarcinoma, Transitional Cell
dc.subject.meshCombined Modality Therapy
dc.subject.meshDeoxycytidine
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMaximum Tolerated Dose
dc.subject.meshMiddle Aged
dc.subject.meshProspective Studies
dc.subject.meshRadiation-Sensitizing Agents
dc.subject.meshRadiotherapy, Conformal
dc.subject.meshUrinary Bladder Neoplasms
dc.titlePhase I study of conformal radiotherapy with concurrent gemcitabine in locally advanced bladder cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Urology, Christie Hospital NHS Trust, Manchester M20 4XB, UK.en
dc.identifier.journalInternational Journal of Radiation Oncology, Biology, Physicsen
html.description.abstractPURPOSE: 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.


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