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

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
DOI: 10.1016/j.ejso.2014.07.043 Publication Date: 2014-09-28T13:02:49Z
ABSTRACT
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.
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