Evaluation of the effects of intra-arterial chemotherapy combined with intravesical chemotherapy against intravesical chemotherapy alone after transurethral resection of bladder tumor in T1-staged Grade 3 bladder cancer
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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.
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.
Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in T1G3 bladder cancer.
KeywordsBladder cancer T1G3 Intra-arterial chemotherapy Intravesical chemotherapy Transurethral resection of bladder tumor
This work was supported by grants from the National Natural Science Foundation of China (No.81402116) and Science and Technology Planning Project of Guangdong Province, China (Nos.2014A020212116, 2018A030307047) and Natural Science Foundation of Guangdong Province, China (No. 2017A030313847), Medical Scientific Research Foundation of Guangdong Province (A2018053), Shantou Science and Technology Project-Medical Treatment and Public Health Category (180709154010294).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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