Treatment Results of Radiotherapy Combined with Balloon-occluded Arterial Infusion Chemotherapy for Invasive Bladder Cancer

We present preliminary results from our clinical study evaluating the effectiveness of combination of radiotherapy with balloon-occluded arterial infusion (BOAI) and hemodialysis (HD) for bladder cancer.

We investigated 134 patients with a median age of 67 years (range=38-88 years) and a median follow-up time of 31 months. According to the UICC classification, 89 patients were at clinical stage T2, 40 at T3, and 5 at T4. All patients received external-beam radiation therapy (EBRT) of 50 Gy to the whole pelvis with 10 Gy to the bladder as a boost. During EBRT, BOAI of cisplatin (CDDP) (100 mg/body) was administered from bilateral internal iliac arteries with simultaneous HD to prevent back-flow of CDDP into the systemic circulation.

Three-year local control and overall survival (OS) rates were 68% and 80%, respectively, and 3-year bladder preservation rate was 90%. Univariate and multivariate analysis showed that T stage and primary effect were significant prognostic factors for OS. In addition, primary effect was a significant prognostic factor for bladder preservation. None of the patients had grade 2 or more severe hematological toxicity. Late grade ≥3 genitourinary (GU) and gastrointestinal (GI) complications were observed in 6% and 2% of the patients, respectively.

Combination of radiotherapy with BOAI and HD, associated with reduced hematological toxicity, may be regarded as a curative therapy for patients with bladder cancer. Late GU and GI complications were within acceptable limits. T stage is an important predictive factor for the outcome of this therapy.

Anticancer research. 2016 Feb [Epub]

Hiroto Yoshioka, Taiju Shimbo, Ken Yoshida, Nobuhiko Yoshikawa, Yasuo Uesugi, Kazuhiro Yamamoto, Haruhito Azuma, Yoshifumi Narumi

Department of Radiation Oncology, Osaka Medical College, Takatsuki, Osaka, Japan Department of Radiation Oncology, Osaka Medical College, Takatsuki, Osaka, Japan. , Department of Radiation Oncology, Osaka Medical College, Takatsuki, Osaka, Japan. , Department of Radiation Oncology, Osaka Medical College, Takatsuki, Osaka, Japan. , Department of Radiation Oncology, Osaka Medical College, Takatsuki, Osaka, Japan. , Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan. , Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan. , Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan.

PubMed