Five patients between 72 and 82 years old received 5 to 6 treatments of 50 to 75 mg. per m.2
cisplatin by bilateral internal iliac artery infusion for unirradiated invasive
transitional cell carcinoma of the bladder. Of the patients 3 also were diabetics and 1 had
congestive heart failure. Treatment was tolerated extremely well, although most courses were associated with moderate to severe
nausea and
vomiting lasting several hours. Of 4 evaluable patients 3 achieved complete remission and 1 achieved a good partial remission. An additional 55-year-old woman with a large invasive bladder
carcinoma fixed to surrounding structures was treated with 4 courses of 100 mg. per m.2 intra-arterial
cisplatin. This patient had a marked decrease in
tumor size, permitting surgical resection of all known
residual tumor. A 49-year-old patient with large pelvic
lymph node metastases from a
squamous cell carcinoma of the bladder achieved only minimal decrease in
tumor size after 3 courses of 100 mg. per m.2 intra-arterial
cisplatin. We conclude that intra-arterial
cisplatin can be highly effective for localized invasive
bladder cancer even when relatively low doses are used. With proper care the regimen can be used safely and effectively in elderly patients with
medical contraindications to an operation.