Treatment Results of Radiotherapy Combined with Balloon-occluded Arterial Infusion Chemotherapy for Invasive Bladder Cancer.

Abstract

AIM:

We present preliminary results from our clinical study evaluating the effectiveness of combination of radiotherapy with balloon-occluded arterial infusion (BOAI) and hemodialysis (HD) for bladder cancer.

PATIENTS AND METHODS:

We investigated 134 patients with a median age of 67 years (range=38-88 years) and a median follow-up time of 31 months. According to the UICC classification, 89 patients were at clinical stage T2, 40 at T3, and 5 at T4. All patients received external-beam radiation therapy (EBRT) of 50 Gy to the whole pelvis with 10 Gy to the bladder as a boost. During EBRT, BOAI of cisplatin (CDDP) (100 mg/body) was administered from bilateral internal iliac arteries with simultaneous HD to prevent back-flow of CDDP into the systemic circulation.

RESULTS:

Three-year local control and overall survival (OS) rates were 68% and 80%, respectively, and 3-year bladder preservation rate was 90%. Univariate and multivariate analysis showed that T stage and primary effect were significant prognostic factors for OS. In addition, primary effect was a significant prognostic factor for bladder preservation. None of the patients had grade 2 or more severe hematological toxicity. Late grade ≥3 genitourinary (GU) and gastrointestinal (GI) complications were observed in 6% and 2% of the patients, respectively.

CONCLUSION:

Combination of radiotherapy with BOAI and HD, associated with reduced hematological toxicity, may be regarded as a curative therapy for patients with bladder cancer. Late GU and GI complications were within acceptable limits. T stage is an important predictive factor for the outcome of this therapy.

• Authors: Hiroto Yoshioka, Taiju Shimbo, Ken Yoshida, Nobuhiko Yoshikawa, Yasuo Uesugi, Kazuhiro Yamamoto, Haruhito Azuma, Yoshifumi Narumi
• Journal: Anticancer research (Anticancer Res) Vol. 36 Issue 2 Pg. 731-6 (Feb 2016) ISSN: 1791-7530 [Electronic] Greece
• PMID: 26851031 (Publication Type: Clinical Study, Journal Article)
• Copyright: Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, adverse effects)
• Balloon Occlusion (adverse effects, mortality)
• Chemoradiotherapy (adverse effects, methods, mortality)
• Cisplatin (administration & dosage, adverse effects)
• Female
• Humans
• Iliac Artery
• Infusions, Intra-Arterial
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Staging
• Proportional Hazards Models
• Radiotherapy, Conformal (adverse effects, mortality)
• Time Factors
• Treatment Outcome
• Urinary Bladder Neoplasms (mortality, pathology, therapy)