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- Title
A prospective comparison of intra-arterial chemotherapy combined with intravesical chemotherapy and intravesical chemotherapy alone after transurethral resection with a thulium laser in high-risk non-muscle invasive bladder cancer.
- Authors
Sun, Feng; Zhao, Ruizhe; Zhu, Yiyong; Cui, Di; Wang, Xiaohai; Han, Bangmin; Liang, Shengjie; Liu, Haitao; Sun, Xiaowen; Zhao, Fujun; Xu, Dongliang; Xia, Shujie
- Abstract
Objective To compare intra-arterial chemotherapy combined with intravesical chemotherapy with intravesical chemotherapy alone in the treatment of high-risk non-muscle invasive bladder cancer (HRBC) after thulium laser resection of a bladder tumor (TmLRBT).<bold>Materials and Methods: </bold>From January 2009 to December 2013, 283 patients with HRBC were randomly assigned to the combined group (group A, n = 141) or intravesical chemotherapy-alone group (group B, n = 142) after TmLRBT. Intra-arterial chemotherapy was administered after initial TmLRBT, with 3 courses at 4-week intervals. Each course consisted of cisplatin (50 mg/m2) and epirubicin (30 mg/m2). Intravesical chemotherapy was administered in both groups, including an immediate 50 mg of epirubicin instillation after TmLRBT and weekly maintenance for 8 weeks, followed by monthly maintenance for 1 year.<bold>Results: </bold>The recurrence rate was 29.1% (41/141) in group A and 42.9% (61/142) in group B, with a significant difference (p = 0.01). The progression rate was 15.6% (22/141) in group A and 25.3% (36/142) in group B, with a significant difference (p = 0.039). Patients with concomitant carcinoma in situ (CIS) also had a lower recurrence rate and progression rate in group A compared to those in group B (p = 0.006 and p = 0.03, respectively). On univariate and multivariate logistic regression analyses, patients with low-grade histology had a higher reccurrence-free rate. Multivariate COX analysis of tumor-related factors suggested that concomitant CIS was the only significant prognostic factor associated with poorer recurrence-free survival and progression-free survival.<bold>Conclusions: </bold>Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in HRBC.
- Subjects
CANCER chemotherapy; TRANSURETHRAL prostatectomy; THULIUM; BLADDER cancer treatment; CISPLATIN; ANTINEOPLASTIC agents; ANTINEOPLASTIC antibiotics; BLADDER tumors; CANCER relapse; CHEMICAL elements; COMBINED modality therapy; COMPARATIVE studies; INTRA-arterial injections; MEDICAL lasers; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; INTRAVESICAL administration; EPIRUBICIN; CYSTECTOMY; TUMOR treatment
- Publication
Cancer Chemotherapy & Pharmacology, 2017, Vol 79, Issue 6, p1099
- ISSN
0344-5704
- Publication type
journal article
- DOI
10.1007/s00280-017-3305-x