Thirty-two patients (30
men, 2 women), median age 68 years (range 47-85) with histologically confirmed advanced bladder
carcinoma (Stages T3 and T4 according to the International Union Against
Cancer staging system), who were poor surgical candidates, were prospectively treated with 1-6 (median 4) cycles of intra-arterial
epirubicin (60 mg/cycle) delivered through two
infusion pumps that were surgically implanted to each internal iliac artery, along with intravenous
leucovorin 200 mg per day and
5-fluorouracil 750 mg per day for three consecutive days. Regional intra-arterial
chemotherapy was well tolerated. There were 12 complete and 10 partial responses for an overall objective response rate of 69%. Eight patients had stable disease and 2 demonstrated progressive disease. All participating patients had gross
hematuria prior to
therapy. After the end of treatment, 24 out of 32 patients had resolution of their gross
hematuria. Eight out of 15 patients with
tumor-associated
dysuria at the time of initiation of
chemotherapy had significant
pain relief at the end of the treatment. Regional intra-arterial
chemotherapy is a safe and effective technique for patients with advanced, muscle invasive bladder
carcinoma and can improve the quality of life of most affected patients by decreasing the degree of
hematuria and
dysuria associated with this
malignancy.