Neoadjuvant chemotherapy with epidoxorubicin in carcinoma of the bilharzial bladder

ABSTRACT

Thirty-seven patients with T2-3 carcinoma of the bilharzial bladder were r and omized to neoadjuvant treatment with epidoxorubicin followed by radical cystectomy [group I] or radical cystectomy alone [group II]. Two cycles of epidoxorubicin [120 mg/m 2] were given on days 1 and 22 of the program followed by cystectomy within 2-4 weeks and 4 cycles after cystectomy. The overall response rate was 43.8% with 12.5% clinical complete response and 31.3% clinical partial response. Pathological downstaging correlated with the clinical stage before treatment 50% [2/4] in T2, 44% [4/9] in T3a and 33% [1/3] in T3b tumors. Grade 3 leucopenia, nausea and vomiting and alopecia occurred in 25%, 31% and 43% of group 1 patients, respectively. At 2 years, patients treated with neoadjuvant chemotherapy [group I] showed a trend towards an improved survival and disease free survival. However, the difference was not statistically significant [log rank test,P >0.05]