Abstract: Objective  To investigate the clinical efficacy and safety of radical transurethral photoselective vaporization of bladder tumors (RPVBT) combined with internal iliac artery chemoembolization in the treatment of muscle-invasive bladder cancer(T2N0M0) in elderly and high-risk patients. 
Methods  The clinical data were collected from 108 patients with muscle-invasive bladder cancer(T2N0M0), who chose to undergo RPVBT or radical transurethral resection ofbladder tumors(RTURBT) combined with internal iliac artery chemoembolization due to intolerance or reluctance to undergo radical cystectomy(RC).According to different types of surgical methods performed, they were divided into the RTURBT group(n=47) and the RPVBT group(n=61). The duration of operation, intraoperative blood loss, obturator nerve reflex, length of hospital stay, survival rate, recurrence rate and overall incidence of adverse effects after internal iliac artery chemoembolization were analyzed and compared between the two groups. Overall survival(OS)and progression-free survival(PFS) curves were drawn. 
Results  There were no statistically significant differences between the RPVBT group and the RTURBT group in terms of age, Karnofsky score, maximum tumor diameter, tumor number, location for tumor distribution, pathological grade composition, and gender composition(P＞0.05). In the RPVBT group, the observed variables of intraoperative blood loss, duration of operation, postoperative hematuria days, and length of hospital stay were significantly less or shorter than those in the RTURBT group, and no obturator nerve reflex occurred, suggesting significant differences(P＜0.001). The 5-year cumulative survival rate, PFS rate, and cumulative recurrence rate were 68.0%, 43.3%, and 38.9% in the RPVBT group, and 69.8%, 47.8%, and 45.2% in the RTURBT group, respectively, and there was no statistically significant difference between two groups(P＞0.05). The recurrence characteristics of the two groups were mainly non-invasive recurrence(46.8% vs. 42.6%), and the recurrence rate of muscular invasive bladder cancer was lower(4.3% vs. 4.9%). The adverse reactions overall related to internal iliac artery chemoembolization were low, with good tolerance. 
Conclusion  RPVBT combined with internal iliac artery chemoembolization is more minimally invasive, which has low complications, good tolerance, good safety and effectiveness in the treatment of muscle-invasive bladder cancer. With a satisfactory long-term OS rate, RPVBT can be used as a treatment strategy for high-risk elderly patients who are intolerant or unwilling to undergo radical surgery.

Key words: urinary bladder neoplasms, laser therapy, antineoplastic combined chemotherapy protocols