Long-term intra-arterial infusion chemotherapy with Adriamycin for advanced bladder cancer

Kanoh, Shori; Umeyama, Tomokazu; Nemoto, Shin-ichi; Ishikawa, Satoshi; Nemoto, Ryosuke; Rinsho, K; Yazaki, Tsunetada; Koiso, Kenkichi; Takahashi, Shigeki; Kitagawa, Ryuichi

doi:10.1007/bf00256719

Cited by 10 publications

(8 citation statements)

References 5 publications

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“…Intra-arterial infusion of chemotherapeutic agents is a treatment modality that is designed to obtain a high con centration of the agent on tumor, while minimizing the systemic side effects. Since June 1980, we have been examining intra-arterial infusion chemotherapy by inser tion of catheter from inferior gluteal artery in patients with invasive bladder cancer [3]. In the present study, we reported the long-term effects of the intra-arterial infu sion chemotherapy for invasive bladder cancer.…”

mentioning

confidence: 61%

Intra-Arterial Chemotherapy for Bladder Cancer by Insertion of Catheter from Inferior Gluteal Artery

Noguchi

Miyanaga²,

Ishikawa³

et al. 1991

Urol Int

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Thirty-four patients with locally advanced bladder cancer have been treated with selective intra-arterial infusion of CDDP and/or ADM (IA therapy) prior to planned surgical resection. Follow-up ranged from 25 to 108 months (median 61). Initial tumor stage was cT2 in 10 patients, cT3 in 19 and cT4a in 5. Catheterization technique: gluteal muscles were dissected gently along the muscle fiber to expose the inferior gluteal artery with the patients in prone position, then the catheter was inserted. The tip was wedged in the internal iliac artery below the bifurcation of the superior gluteal artery. ADM 10–20 mg and/or CDDP 10–20 mg were infused once or twice a week. Total dose of ADM and CDDP were 40–580 and 60–240 mg. Thirteen patients received IA therapy + hyperthermia and 8 IA therapy + irradiation. Surgical resection included total cystectomy (22 patients) partial cystectomy (3 patients) and transurethral resection of the prostate (5 patients). Survival rate at 5 years is 57.9% (T2 = 90.0 T3 = 52.1 T4=––). Eighteen patients are alive with no evidence of recurrences, and 11 patients were free of disease for more than 5 years. Side effects were bone marrow suppression (5 patients), vomiting (4), erosion of gluteal skin (7), and neurotoxicity, such as sensory disturbance in lower extremities or ischialgia (2); treatment was well tolerated in others. In conclusion, our results suggest that intra-arterial infusion of ADM and/or CDDP by insertion of catheter from inferior gluteal artery is safe with minimal systemic side effects, and prolongs survival for invasive bladder cancer.

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mentioning

confidence: 61%

Intra-Arterial Chemotherapy for Bladder Cancer by Insertion of Catheter from Inferior Gluteal Artery

Noguchi

Miyanaga²,

Ishikawa³

et al. 1991

Urol Int

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“…In the 1980s-1990s, multiple efforts were made to improve oncological outcomes by adding various IAC treatment modalities plus RC to treatment regimens for MIBC. A summary of the published neoadjuvant IAC papers, including key information on chemotherapy regimens, is provided in Table 6 ( Figure S5) (13)(14)(15)(16)(17)(18)(19)(20)(21). Although most of the literature is early in its use, the drugs also have differences, but all show varying degrees of pathological downstaging or even complete response (CR; pT0).…”

Section: Discussionmentioning

confidence: 99%

The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

Wahafu

Liu

et al. 2019

Preprint

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Background: Bladder cancer is a complex disease associated with high morbidity and mortality. The management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC)versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. Methods: We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. Propensity-score matching (1:3) was performed based on key characteristics. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazards model was used to estimate survival outcomes. Results: Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between the groups in baseline characteristics, perioperative variables, complication outcomes or tumour characteristics. Compared with the clinical tumour stages, the pathological tumour stages demonstrated a significant decrease (P=0.002) in the IAC group. There was no significant difference in overall survival (OS, p=0.354) or cancer-specific survival (CSS, p=0.439) between the groups. Among all patients, BMI significantly affected OS (p=0.004), and positive lymph nodes (PLN) significantly affected both OS(p＜0.001) and CSS (p=0.010). Conclusions: One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.

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“…In the 1980s-1990s, multiple efforts were made to improve oncological outcomes by adding various IAC treatment modalities plus RC to treatment regimens for MIBC. A summary of the published neoadjuvant IAC papers, including key information on chemotherapy regimens, is provided in Table 6 ( Figure S10) (13)(14)(15)(16)(17)(18)(19)(20)(21). Although most of the literature is early in its use, the drugs also have differences, but all show varying degrees of pathological downstaging or even complete response (CR; pT0).…”

Section: Discussionmentioning

confidence: 99%

The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

Wahafu

Liu

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Bladder cancer is a complex disease associated with high morbidity and mortality. Management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC) versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. Methods: We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. A propensity-score matching (1:3) was performed based on key characters. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazard model was used to estimate survival outcomes. Results: Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between groups in baseline characteristics, perioperative variables, complication outcomes or tumor characteristics. Compared with clinical tumor stages, pathological tumor stages demonstrated a significant decrease (P=0.002) in the IAC group. There was no significant difference in overall survival (OS, p=0.354) or cancer-specific survival (CSS, p=0.439) between the groups. Among all patients and in the NIAC group, BMI significantly affected OS (p=0.004 and p=0.014, respectively), and positive lymph nodes significantly affected both OS (p＜0.001, both) and CSS (p=0.010 and p=0.017, respectively). Only diabetes involvement at the time of IAC was significantly associated with worse overall mortality (p=0.004). Conclusions: One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.

show abstract

Long-term intra-arterial infusion chemotherapy with Adriamycin for advanced bladder cancer

Cited by 10 publications

References 5 publications

Intra-Arterial Chemotherapy for Bladder Cancer by Insertion of Catheter from Inferior Gluteal Artery

Intra-Arterial Chemotherapy for Bladder Cancer by Insertion of Catheter from Inferior Gluteal Artery

The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

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