Bin Huang1, Hua Wang2, Hao Lin3, Zhijun Yao4, Jiabo Zheng5, Wenzhe Fan6, Shaopeng Qiu1,7, Lingwu Chen8, Junxing Chen9. 1. Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou, 510080, China. 2. Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, No.600 Tan He Road, Guangzhou, 510080, China. 3. Department of Urology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China. linh26@mail2.sysu.edu.cn. 4. Department of Urology, The Central Hospital of Hengyang, Hengyang, 421001, China. 5. Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China. 6. Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China. 7. Department of Urology, Hui Ya hospital of The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510000, China. 8. Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou, 510080, China. chenlingwu@hotmail.com. 9. Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou, 510080, China. cjxsysums@163.com.
Abstract
OBJECTIVE: Comparing intra-arterial chemotherapy combined with intravesical chemotherapy against intravesical chemotherapy alone in the treatment of T1-stagedGrade 3 (T1G3) bladder cancer after transurethral resection of bladder tumor (TURBT). MATERIALS AND METHODS:From January 2007 to December 2012, 203 patients diagnosed with NMIBC were randomly assigned into either intra-arterial chemotherapy combined with intravesical chemotherapy group (Group A, n = 68) or intravesical chemotherapy alone group (Group B, n = 135) after TURBT. Four cycles of intra-arterial chemotherapy were administered after initial TURBT with 1-month interval between each. Intravesical chemotherapy was administered in both groups including an immediate 50 mg epirubicin instillation after TURBT and weekly maintenance for 8 weeks, and then followed by monthly maintenance for 1 year. The primary endpoint was recurrence-free survival. RESULTS: Out of 203 patients, 53 were in Group A and 98 in Group B, and they were evaluated for recurrence and progression rate where recurrence rate was 35.8% (19/53) in group A and 41.8% (41/98) in group B with a significant difference (P < 0.05) and progression rate was 20.7% (11/53) in group A and 23.5% (23/98) in group B with a significant difference (P < 0.05). Univariate and multivariate logistic regression analysis suggested that intra-arterial chemotherapy could be an independent risk factors related to both overall survival and time to first recurrence. CONCLUSIONS:Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in T1G3 bladder cancer.
RCT Entities:
OBJECTIVE: Comparing intra-arterial chemotherapy combined with intravesical chemotherapy against intravesical chemotherapy alone in the treatment of T1-staged Grade 3 (T1G3) bladder cancer after transurethral resection of bladder tumor (TURBT). MATERIALS AND METHODS: From January 2007 to December 2012, 203 patients diagnosed with NMIBC were randomly assigned into either intra-arterial chemotherapy combined with intravesical chemotherapy group (Group A, n = 68) or intravesical chemotherapy alone group (Group B, n = 135) after TURBT. Four cycles of intra-arterial chemotherapy were administered after initial TURBT with 1-month interval between each. Intravesical chemotherapy was administered in both groups including an immediate 50 mg epirubicin instillation after TURBT and weekly maintenance for 8 weeks, and then followed by monthly maintenance for 1 year. The primary endpoint was recurrence-free survival. RESULTS: Out of 203 patients, 53 were in Group A and 98 in Group B, and they were evaluated for recurrence and progression rate where recurrence rate was 35.8% (19/53) in group A and 41.8% (41/98) in group B with a significant difference (P < 0.05) and progression rate was 20.7% (11/53) in group A and 23.5% (23/98) in group B with a significant difference (P < 0.05). Univariate and multivariate logistic regression analysis suggested that intra-arterial chemotherapy could be an independent risk factors related to both overall survival and time to first recurrence. CONCLUSIONS: Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in T1G3 bladder cancer.