Intra-arterial infusion chemotherapy for invasive bladder cancer

A total of 57 patients with invasive bladder cancer (T2 4, N0, M0) was treated with arterial infusion chemotherapy and their treatment outcome was evaluated. Each patient was given 70 mg/m² of CDDP and 40 mg/m² of ADM. During the treatment, 2 μg/min of angiotensin II were also administrated. Of 56 evaluable patients, CR was obtained in 9 patients, PR in 32, NC in 14 and PD in 1, providing an overall response rate of 73%. Following arterial infusion chemotherapy, total cystectomy was performed in 24 patients while bladder sparing therapy was performed in 32 patients. The follow up duration ranged from 3 to 128 months (median 34 months, average 41 months). The cause specific 5 year survival rate was 54% and the median survival duration was 61 months. Among patients treated with the bladder sparing approach, the cause specific 5 year survival rate was 65% and the event free 5 year survival rate was 26%, with the median event free duration being 29 months. The pathological T stage was lower than the clinical T stage in 12 out of 24 patients treated with total cystectomy, while the cause specific 5 year survival rate was 43%. Although the clinical response to this arterial infusion chemotherapy was encouraging, a bladder sparing approach based on this therapy was of only limited success. It remains unclear whether or not arterial infusion chemotherapy can improve prognosis for total cystectomy patients.