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Abstract
Bladder cancer is the fourth common cancer among males and the eighth most common cancer among females. In the united states, it’s estimated that more than 61.420 new cases diagnosed in 2006, and approximately 30.060 died from the disease (Robert Dircer, et al., 2006 In Egypt, bladder cancer is a major health care problem approximately 5118 new cases are estimated in 2004. Which represent 8.4% of all new cancer cases. Bladder cancer is common in Egypt due to Bilharziasis, incidence is more common in men than women and its incidence increase with age (El- Sherify et al., 2004 Bladder cancer is common malignancy characterized by frequent recurrence and poor clinical outcome when tumor progress into invasive disease (Carlos et al., 2006 In the last three decades, radical cystectomy remains the treatment of choice for carcinoma of bilharzial bladder. Local recurrence accounts for approximately 75% of the failure of this treatment (Zaghloul M.S 1996 Organ preservation has been investigated in patients of cancer bladder over the past decades as an alternative to radical cystectomy. The majority of studies reported that radiotherapy and chemoradiotherapy appeared to provide high response rates and can be offered as an alternative to radical cystectomy in selected patients who refuse or are unsuitable for surgery. In the last decades, several articles have reported encouraging data regarding the response rate and survival of patients with non-metastatic cancer bladder using combined modality treatment with bladder preservation (Filina orefici et al., 2004 Concomittent radiotherapy and cisplatin is used in treatment of non-metastatic cancer bladder, Experimental and clinical data suggest that cisplatin-Radiotherapy interaction is enhanced when radiotherapy is administrated in multiple fractions and cisplatin is less toxic and more effective. Concomittent administration of chemoradiotherapy demonstrated in experimental and clinical studies, appears to increase response rates compared with other combination used in the past. In cisplatin-based chemotherapy, renal impairment may be major factor limiting its use (Filina Orefici et al., 2004 Radiosensitizers are compounds that when combined with radiation, will achieve greater tumor inactivation