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Trial on neoadjuvant chemotherapy in bladder cancer

An important trial of 'up-front' (neoadjuvant) chemotherapy was reported at this year's influential American Society of Clinical Oncology meeting in San Francisco (May '01) by workers from a multi-institutional group. 317 patients with locally advanced bladder cancer were randomised to either receive chmeotherapy (MVAC) before surgical resection of the bladder (cystectomy) or not. Survival in the MVAC arm of the trial was significantly better to that in the surgey only arm, (6.2 versus 3.8 years).
 
This trial strongly supports the use of neoadjuvant chemotherapy in the younger and fitter patients - but the next question already is raising its head - does it also apply to patients who are treated with radical radiotherapy instead of surgery?