Cisplatin as a first-line treatment in T2 and T3 bladder carcinoma.

Twenty-two patients with bladder cancer stage T2 or T3NxM0 received preirradiation treatment with cisplatin. Three complete and seven partial remissions were achieved. Responders received additional cisplatin concomitantly with radiotherapy, for a total of eight complete remissions. Toxicity from cisplatin alone or in combination with radiotherapy was moderate. Seven of the ten responders following preirradiation cisplatin are alive without evidence of disease. All nonresponders have died due to relapse (follow-up time, 46-80 months). Randomized trials with and without preirradiation cisplatin are warranted to establish whether cisplatin improves the prognosis of patients with invasive bladder cancer.