ABSTRACT
Clinical and pathological factors that affect short-term responses and long-term prognosis of muscle-invasive bladder cancer were studied in 73 patients who underwent a combination of intra-arterial chemotherapy and low-dose radiotherapy. Complete Response (CR) was observed in 41 (56%) of the 73 patients. The frequency of CR was significantly different according to the sex (males 64%, females 29%; p = 0.0239), clinical stage (T2 74%, T3 64%, T4 20%; p = 0.0005), tumor size (< 3 cm 81%. > or = 3 cm 31%; p < 0.0001), and tumor grade (G3 72%, G2 41%, p = 0.0127). By multivariate analysis, a significant difference was observed only in the tumor grade. The 5-year survival rate after bladder-preserving operations (median duration of follow-up 69 months) was significantly different according to the sex (males 75.2%, females 57.1%; p = 0.0427), clinical stage (T2 86.3%, T3 82.3%, T4 33.8%; T2 vs T4, p = 0.0005; T3 vs T4, p = 0.0107), tumor size (< 3 cm 89.6%, > or = 3 cm 47.2%; p = 0.0012), and tumor response (CR 95.0%, non-CR 38.6%; p < 0.0001). By multivariate analysis, a significant difference was observed only in the tumor response. The combination therapy of intra-arterial infusion and irradiation produced excellent short-term effects and prolonged the survival of the patients. Preservation of the bladder is considered to be possible in patients who obtained CR.
