Neo-Adjuvant Intra-Arterial Chemotherapy for Treatment of Locally Advanced Bladder Cancer: Therapeutic Protocol and Preliminary Report

Abstract

Locally advanced bladder cancer (T3ab-T4a NO-1-2 MO) is not always amenable to radical surgery, and the search for the best treatment continues. The 5-year survival rate is generally 12%–20% for T3 tumors [1, 2] and 5% for T4 tumors [3, 4]. New (preoperative) neo-adjuvant therapy protocols intends to produce better results in such bladder tumors have recently been described [5–8]. The biologic rationale for this kind of treatment is that the drugs achieve a very high concentration in the neoplasm, more than with systemic administration, and toxicity, in contrast is slight. Cisplatin + 4-epidoxorubicin has been shown to be one of the more active combinations [8, 9].