This protocol addresses locally advanced squamous cell carcinoma (SCC) of the urethra, staged T3–T4 with regional nodal involvement up to N2 and no distant metastases (M0), in patients whose primary treatment has not resulted in a complete clinical response.
Squamous cell carcinoma of the urethra at stage T3–T4, N0–N2, M0. This represents locally advanced disease with potential regional nodal involvement but no evidence of distant spread.
The preceding treatment line comprised curative external beam radiotherapy with concurrent chemotherapy (including 5-fluorouracil and mitomycin C) aimed at definitive treatment and genital preservation, combined as appropriate with inguinal lymph node dissection, neoadjuvant chemotherapy, or adjuvant radiotherapy depending on nodal status. Escalation to this protocol is triggered when that treatment did not achieve complete clinical response, or in the setting of subsequent local failure.
For patients who are non-responders or who experience local failure after primary treatment, a salvage-based approach is indicated. The complete structured regimen and the full range of clinical decision points are available via the link below.