Efficacy and safety of systemic chemotherapy and intra-arterial chemotherapy with/without radiotherapy for bladder preservation or as neo-adjuvant therapy in patients with muscle-invasive bladder cancer: A single-centre study of 163 patients

• DOI: 10.1016/j.ejso.2014.07.043
• Publication Date: 2014-09-28T13:02:49Z
• Authors: Y. Miyata; K. Nomata; K. Ohba; T. Matsuo; N. Hayashi; I. Sakamoto; M. Uetani; H. Sakai
• Keywords: Male; Cystectomy; Carboplatin; 03 medical and health sciences; 0302 clinical medicine; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy; Humans; Infusions, Intra-Arterial; Neoplasm Invasiveness; Preoperative treatment; Aged; Aged, 80 and over; Carcinoma, Transitional Cell; Radiotherapy; Bladder cancer; Chemoradiotherapy; Chemoradiotherapy, Adjuvant; Middle Aged; Prognosis; Neoadjuvant Therapy; 3. Good health; Oncology; Chemotherapy, Adjuvant; Adverse events; Multivariate Analysis; Surgery; Female; Fluorouracil; Cisplatin; Organ Sparing Treatments

Patients with muscle-invasive bladder cancer (MIBC) often undergo various preoperative treatments to improve survival; however, their efficacy and safety remain unclear.The anti-tumour effects and adverse events were evaluated in 163 MIBC patients who received systemic chemotherapy (SC, n = 34), intra-arterial chemotherapy (IAC, n = 50), or combined IAC and radiotherapy (IAC + R, n = 79).Pathological complete responses were observed in 17.6%, 22.0%, and 43.0% of patients in the SC, IAC, and IAC + R groups, respectively, with respective 5-year overall survival rates of 42.0%, 46.7%, and 50.3%. Multivariate analysis showed that successful IAC + R protocol administration was a significant predictor for survival (hazard ratio = 0.16, p = 0.028). The incidence of severe adverse events was higher in the IAC + R group (36.7%) than in the SC (9.8%) and IAC groups (16.0%).IAC + R was useful for patients with MIBC. Successful completion and optimal patient selection were important for this treatment strategy.