Combination of intraarterial chemotherapy, three dimensional conformal radiotherapy and transurethral photoselective vaporization for the treatment of muscle-invasive bladder cancer

Abstract

Objective To evaluate the efficacy of bladder preservation treatment by combining intraarterial chemotherapy,three dimensional conformal radiotherapy and transurethral photoselective vaporization for muscle-invasive bladder cancer.Methods A total of 16 patients (13 males and 3 females; mean age,74 years; age range,68-86 years) with muscle-invasive bladder cancer underwent bladder preservation treatment,who refused or could not tolerate the radical cystectomy (11 cases with cardiovascular and cerebrovascular disease,3 cases with severe chronic obstructive pulmonary disease and other 2 cases refused radical cystectomy as initial therapeutic option).The tumor stages were T2(9 cases),T3(7 cases) and tumor grades were G1(3 cases),G2(10 cases) and G3(3 cases).The mean diameter of tumor was 3.5 cm (range from 3 cm to 6 cm).They received intraarterial chemotherapy,three dimensional conformal radiotherapy and transurethral photoselective vaporization.The chemotherapy regimen consisted of cisplatin 80 mg and pirarubicin 40 mg.The average dose of radiotherapy was 30-40 Gy.Results After intraarterial chemotherapy and three dimensional conformal radiotherapy,all the tumors were necrosis and dwindled significantly and 5 patients showed a complete response.The patients were follow up for 3-43 months after transurethral photoselective vaporization of the residual tumor.Recurrent non-muscle invasive tumors were found in 2 patients and were treated transurethrally.Overall,2 patients died of cerebrovascular accident.Conclusion Combination of intraarterial chemotherapy,three dimensional conformal radiotherapy and transurethral photoselective vaporization is safe and effective for the treatment of muscle-invasive bladder cancer. Key words: Urinary bladder neoplasms; Intraarterial chemotherapy; Three dimensional conformal radiotherapy; Photoselective vaporization