Document Detail


A bladder preservation regimen using intra-arterial chemotherapy and radiotherapy for invasive bladder cancer: a prospective study.
MedLine Citation:
PMID:  10710246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A prospective study was performed to investigate combined treatment with intra-arterial chemotherapy and radiation therapy for bladder preservation in locally invasive bladder cancer. METHODS: Patients with invasive bladder cancer, stage T2-3N0M0, were included in the study. Intra-arterial chemotherapy was performed with three injections of methotrexate and cisplatin at 3-week intervals. Simultaneously, the patients underwent X-ray irradiation (40 Gy) of the small pelvic space. Where a post-treatment transurethral resection (TUR) biopsy showed no residual tumor, the tumor site was irradiated by a 30 Gy proton beam and the bladder was preserved. Where tumors remained, radical cystectomy was performed. RESULTS: Between 1990 and 1996, 42 patients were treated according to this protocol. Post-treatment TUR biopsy and urine cytology showed no residual tumors in 39 of 42 cases (93%). The bladder was preserved in accordance with the study protocol in 36 cases. A median follow-up of 38 months showed 3-year non-recurrence in 72% of bladder-preserved patients and the rate of bladder preservation was 84%. The nine recurrences included eight cases of superficial bladder recurrence. One cancer death occurred among the bladder-preservation patients, giving 3-year survival and cause-specific survival rates of 84% and 100%, respectively. Although bladder function decreased slightly in compliance, bladder capacity was retained in almost all cases. CONCLUSIONS: This regimen is useful for bladder preservation in T2-3 locally invasive bladder cancer. Information from more cases and the results of more long-term observations are needed, as is an evaluation of appropriate subject selection and factors associated with quality of life issues, particularly regarding bladder function.
Authors:
N Miyanaga; H Akaza; T Okumura; N Sekido; K Kawai; T Shimazui; K Kikuchi; K Uchida; H Takeshima; K Ohara; Y Akine; Y Ita
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  7     ISSN:  0919-8172     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-04-03     Completed Date:  2000-04-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  41-8     Citation Subset:  IM    
Affiliation:
Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan. nao-miya@md.tsukuba.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Antineoplastic Agents / administration & dosage*
Cisplatin / administration & dosage*
Combined Modality Therapy
Female
Humans
Injections, Intra-Arterial
Male
Methotrexate / administration & dosage*
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local / epidemiology
Neoplasm Staging
Prognosis
Prospective Studies
Treatment Failure
Urinary Bladder Neoplasms / drug therapy*,  pathology,  radiotherapy*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 15663-27-1/Cisplatin; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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