Intra-arterial chemotherapy for local invasive bladder cancer.

Abstract

e15063 Background: We assessed the effectiveness of intra-arterial chemotherapy or a combination of intra-arterial chemotherapy and external beam radiation therapy. Methods: Between 1993- 2007, 73 patients with muscle invasive bladder cancer (stage T2-4N0M0) were treated with intra-arterial chemotherapy (53 cases) or a combination of intra-arterial chemotherapy and low dose external beam radiation therapy (20 cases). Low dose radiation therapy was given at dose of 2 Gy x 5 days. 53 cases were treated with 50 or 70/m2 of cisplatin (CDDP) and 20mg/m2 of doxorubicin (ADM) intra arterially. Median 3 courses (range 2-6 course) of therapy were performed. Each course of therapy was repeated every 4 weeks. 20 cases were treated with intra-arterial chemotherapy and low dose external beam radiation therapy. Radical cystectomy was required for 15 patients. Median follow up was 29 months (range 4-180 months). Results: CR was achieved in 38% (28) of patients. PR was 44% (32) of patients. Five- and ten-year over all survival rates were 60% and 54%. 53% (39) of patients survive with preserving their bladder. 21% died of cancer. The regimen was well tolerated, with no severe systemic or local toxicities. Conclusions: These findings suggest that Intra-arterial chemotherapy is a reasonable option for patients seeking an alternative to radical cystectomy.