Radiation therapy and concurrent daily intra-arterial infusion of low-dose cisplatin following alteration of pelvic blood flow for invasive bladder cancer: a preliminary report.
Concurrent intra-arterial infusion chemotherapy and radiation therapy following alteration of pelvic blood flow was performed in 15 patients with invasive bladder cancer (T2: 2, T3a: 4, T3b: 5, T4: 4). Infusion chemotherapy consisted of a daily low-dose of cisplatin with a dose range of 7 to 9 mg per patient. Of the 15 patients, 11 achieved complete response (73%) and other had partial response. Four of those with CR developed recurrence (local recurrence in three and distant metastasis in one patient). Cause specific and disease-free survival at 3-years were 56% and 49.9%, respectively, and the bladder preservation rate at 3-year was 47%. Toxic reactions related to the treatment was of a reasonable level, and cisplatin-induced renal dysfunction was not experienced, even in the patients with poor renal function, although transient neutropenia and thrombocytopenia occurred in all patients at the latter stage of the treatment. This treatment modality is considered to be effective and feasible even in patients with locally advanced disease and/or those unsuited for cisplatin-based systemic chemotherapy.