Internal Iliac Arterial Infusion Chemotherapy for Rabbit Invasive Bladder Cancer

Abstract

Background: Internal iliac arterial infusion (IA) chemotherapy has been used clinically for locally invasive bladder cancer, but there have been no experimental studies to actually demonstrate whether IA is more effective than intravenous infusion (IV) chemotherapy in this setting. Methods: We compared the effects of IA and IV using a rabbit invasive bladder cancer model. A 0.2 mL suspension containing 2 x lo6 VX2 cancer cells was inoculated into the posterior submucosa of the bladder. Two weeks later the rabbits were divided into 3 treatment groups of 8 rabbits each: controls, a group treated with IA consisting of 10 m d k g carboplatin and 1 mg/kg pirarubicin once a week for 3 weeks (days 14, 21, and 28), and the third treated with the same regimen intravenously.Results: All bladder tumors of the rabbits in the IA group decreased in size, and 3 of the tumors totally disappeared (37.5%). There was also no evidence of lung metastasis. All tumors in the rabbits in the IV treatment group increased in size (tumor volume of IA vs. IV, P = 0.008) and 2 rabbits had lung metastases. All tumors of the control group increased in size and all rabbits had lung metastases. The concentrations of platinum and pirarubicin in the bladder tumors were significantly higher in the IA treatment group than those in the IV treatment group at time points from 5 to 10 minutes ( P < 0.05) after drug infusion. Conclusion:The antitumor effect of IA may be due to higher drug concentrations in the early stage after drug delivery, and the initial circulation of high concentrationsof drugs may be the most important factor Int

The Efficacy of Intra-Arterial Plus Intravesical Chemotherapy Versus Intravesical Chemotherapy Alone After Bladder-Sparing Surgery in High-Risk Bladder Cancer: A Systematic Review and Meta-Analysis of Comparative Study

“…The idea of IAC is to inject chemotherapeutic drugs directly into the blood vessels leading to the neoplastic organs, so that the concentration of antitumor drugs in the neoplastic organs will be higher, achieving the more effective distribution ( 38 , 39 ). However, adverse reactions related with IAC should not be ignored.…”

Early Tumor Response to Intraarterial or Intravenous Administration of Carboplatin to Treat Naturally Occurring Lower Urinary Tract Carcinoma in Dogs

“…A proposed advantage of IAC over IVC is the lower potential adverse effects associated with chemotherapy . Research in laboratory rabbits with bladder tumors determined that internal iliac artery infusion of carboplatin and pirarubicin was safely tolerated and resulted in significantly higher chemotherapy levels within the bladder tumor itself . In addition, all tumors receiving intraarterial treatment reduced in size with 37.5% disappearing compared to those receiving intravenous treatment in which all tumors grew in size .…”

“…Research in laboratory rabbits with bladder tumors determined that internal iliac artery infusion of carboplatin and pirarubicin was safely tolerated and resulted in significantly higher chemotherapy levels within the bladder tumor itself . In addition, all tumors receiving intraarterial treatment reduced in size with 37.5% disappearing compared to those receiving intravenous treatment in which all tumors grew in size . The improved efficacy of intraarterial drug delivery is thought to result from the initial increased drug concentration in the tumor after intraarterial administration.…”

Diagnosis and treatment of pelvic lymph node metastasis in bladder cancer

“…Our experimental work showed internal iliac arterial infusion chemotherapy is superior to intravenous chemotherapy in invasive bladder cancer. 20 Internal iliac arterial infusion chemotheapy reduced the pelvic recurrence. Pelvic recurrence as the first site was reported 11–25% 21,22 after radical cystectomy for treatment of invasive bladder cancer.…”