Clinical Trials
(RTOG 0233 )

   
RTOG 0233 Bladder Preservation
A Phase II Randomized Trial for Patients with Muscle-Invading Bladder Cancer Evaluating Transurethral Surgery and BID Irradiation Plus Either Paclitaxel and Cisplatin or 5-Fluorouracil and Cisplatin Followed by Selective Bladder Preservation and Gemcitabine/Paclitaxel/Cisplatin Adjuvant Chemo.

General Information

Purpose
This study is for persons with bladder cancer that invades muscle and who could potentially undergo surgery with removal of the bladder (Cystectomy). The goal of the study is to determine if Transurethral Resection of the Bladder (TURB) followed by two different chemotherapy regimens combined with radiation can prevent the need for a Cystectomy thereby preserving the bladder. This study is also evaluating which of the two chemotherapy regimens is most effective and the side effects of both treatments.
Protocol Number
RTOG 0233
Eligibility Criteria
  • Biopsy proven bladder cancer with evidence of invasion into muscle.
  • Stage T2 - 4a without hydronephrosis.
  • Lymph nodes must be negative by CT or if positive by CT negative by biopsy.
  • There must be no spread to other parts of the body.
  • Patients must have a functioning bladder.
  • Treatment must begin within 8 weeks of TURB.
  • No concurrent or prior malignancies unless disease free for 5 years (non-melanoma skin cancer, Stage T1a prostate or carcinoma in-situ of the uterine cervix is OK).
  • No previous chemotherapy or pelvic radiation therapy.
Treatment Plan
Participants will be assigned by chance to one of the following treatments:

Chemotherapy consisting of Taxol and Cisplatin given during radiation. The Chemotherapy will be given intravenously for the first 3 days of each week of radiation therapy. Radiation therapy will be given initially for a total of 13 treatments (over 3 weeks), Monday through Friday. After this treatment is complete, a cystoscopy of the bladder and biopsies will be done to determine if the tumor has responded to treatment. If the cancer has responded an additional 8 radiation treatments (over 2 weeks) will be given along with chemotherapy (Taxol and Cisplatin) during the first 3 days of each week. If there is still cancer in the bladder, removal of the bladder will be recommended.

OR

Chemotherapy consisting of 5-FU and Cisplatin given during radiation. The Chemotherapy will be given intravenously for the first 3 days of each week of radiation therapy. Radiation therapy will be given initially for a total of 13 treatments (over 3 weeks), Monday through Friday. After this treatment is complete, a cystoscopy of the bladder and biopsies will be done to determine if the tumor has responded to treatment. If the cancer has responded an additional 8 radiation treatments (over 2 weeks) will be given along with chemotherapy (5-FU and Cisplatin) during the first 3 days of each week. If there is still cancer in the bladder, removal of the bladder will be recommended.

All patients will receive additional chemotherapy (4 courses) consisting of Gemzar, Taxol and Cistplatin after their initial treatment is complete (either surgery or radiation and chemotherapy alone).
Contact Information
For additional information regarding this study, contact the Clinical Research Associates at Radiological Associates, Radiation Oncology Center, Sacramento (916) 454-6699 X80382 or 80383.
Date Updated
05/19/2006