Preliminary results of bladder preservation by concurrent intraarterial chemotherapy and radiotherapy for muscle-invasive bladder cancer

• Published in: International journal of urology 1998-05, Vol.5 (3), p.225
• Main Authors: Sumiyoshi, Y, Hashine, K, Karashima, T, Kasahara, K, Inoue, Y
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Cisplatin - adverse effects; Cisplatin - therapeutic use; Combined Modality Therapy; Doxorubicin - adverse effects; Doxorubicin - analogs & derivatives; Doxorubicin - therapeutic use; Female; Humans; Male; Middle Aged; Muscle, Smooth - pathology; Neoplasm Invasiveness - pathology; Treatment Outcome; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - radiotherapy
• ISSN: 0919-8172
• DOI: 10.1111/j.1442-2042.1998.tb00594.x

We previously reported favorable results of intraarterial doxorubicin chemotherapy in combination with low-dose radiotherapy for locally-advanced bladder cancer. We have now designed a new intraarterial chemotherapy regimen to achieve a higher tumor response rate while preserving a functional bladder. Twenty-one patients with muscle-invasive bladder cancer (T2,10; T3,7; T4,4) were treated with concurrent intraarterial chemotherapy and radiotherapy after an initial complete transurethral resection. Induction therapy consisted of concomitant pirarubicin (THP; 15 mg/m2/day on days 1 to 3), cisplatin (CDDP; 25 mg/m2/day on days 8 to 10) and irradiation (2 Gy/session on days 1 to 3 and 8 to 10). Maintenance treatment consisted of THP administered at 20 or 30 mg with or without 50 mg CDDP every month for 2 years. Nineteen of the 21 patients (90.5%) achieved a complete response (CR). One of these 19 relapsed with lung metastases 24 months after treatment and was treated surgically. The 2 patients who did not achieve a CR died of cancer, while the remaining 19 patients are alive with preservation of a functional bladder. These findings suggest that a higher tumor response rate with bladder preservation for patients with muscle-invasive bladder cancer is achieved by intraarterial THP/CDDP chemotherapy plus radiotherapy.