Intraarterial chemotherapy as the first-line therapy in penile cancer

• Published in: British journal of cancer 2014-09, Vol.111 (6), p.1089-1094
• Main Authors: Chiang, P-H, Chen, C-H, Shen, Y-C
• Format: Article
• Language: English
• Subjects: 692/699/67/1059/99; 692/699/67/589/1721; Adult; Aged; Aged, 80 and over; Anorexia - chemically induced; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Biopsy; Bleomycin - administration & dosage; Cancer Research; Cancer therapies; Carboplatin - administration & dosage; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Catheters; Chemotherapy; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Clinical Study; Disease-Free Survival; Drug Resistance; Epidemiology; Fluorouracil - administration & dosage; Genital cancers; Gynecology. Andrology. Obstetrics; Hospitals; Humans; Infusions, Intra-Arterial; Inguinal Canal; Leucovorin - administration & dosage; Lymph Node Excision; Lymphatic Metastasis; Lymphatic system; Male; Male genital diseases; Medical sciences; Methotrexate - administration & dosage; Middle Aged; Mitomycin - administration & dosage; Molecular Medicine; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoadjuvant Therapy; Oncology; Patients; Penile Neoplasms - drug therapy; Penile Neoplasms - pathology; Penile Neoplasms - surgery; Penis; Response rates; Retrospective Studies; Surgery; Toxicity; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2014.394

Background: Limited literature on the role of intraarterial chemotherapy as first-line therapy for penile squamous cell carcinoma is available. Methods: From 2005 to 2013, a total of 12 patients with various stages of penile squamous cell carcinoma received intraarterial chemotherapy. The chemotherapeutic agents used were methotrexate, mitomycin C, bleomycin, cisplatin, and 5-fluorouracil. Surgery was followed by the tumour responses. Results: An objective tumour response was noted in 10 of 12 patients (83%, 4 complete responders and 6 partial responders). In node-negative patients ( n =7), the response rate was 100% (4 complete responders and 3 partial responders). Even in advanced penile squamous cell carcinoma with nodal invasion, a response rate of 60% could be achieved. Grade 2 anorexia was the most frequent chemotherapy-related toxicity and no toxic death was noted. Recurrence-free survival was significantly better in patients without lymph node invasion (log-rank test, P =0.041). Conclusions: Neoadjuvant intraarterial chemotherapy displayed excellent responses for penile squamous cell carcinoma. This therapy could effectively shrink the tumour burden or even achieve complete response before surgery. It could be used as first-line strategy for penile cancer treatment because of low toxicity.