Concurrent chemoradiotherapy with low dose weekly gemcitabine in medically inoperable muscle-invasive bladder cancer patients

Radical cystectomy with pelvic lymphadenectomy has been considered the standard treatment in muscle-invasive bladder cancer patients and 5-year overall survival rates are about 60 %.with this treatment [1] Alternatively, bladderpreserving strategies with maximal transurethral resection of bladder tumor followed by platinum-based chemoradiotherapy has been tested in randomized controlled trials [2–6]. In these studies, the complete response rates reported were 60–90 % and 5-year bladder intact survival rate was 40 % [2, 5, 6]. However, in medically inoperable patients, concomitant therapy may be more challenging due to the risk of enhanced toxicity. Unfortunately, in retrospective series single modality radiotherapy or chemotherapy failed to …