In an article by James et al in the NEJM (2012) the authors report results from the BC2001 study. They argue that the chances of loco-regional control of invasive bladder cancer by radical radiotherapy is enhanced by combining it with synchronous chemotherapy. The study randomised 360 patients to radical (or modified) radiotherapy with or without chemotherapy (5FU and MMC). Over 80% of patients had T2, TCC and all were N0, M0. At 72 months there was an approximate 12% absolute improvement in loco-regional control. At the same time there was a statistically non-significant improvement in mortality.