Maatman T J, Montie J E, Bukowski R M, Risius B, Geisinger M
J Urol. 1986 Feb;135(2):256-60. doi: 10.1016/s0022-5347(17)45602-3.
Regional chemotherapy with intra-arterial cis-platinum and doxorubicin as an adjuvant to total cystectomy and urinary diversion has been evaluated in a phase I to II study. In the first 17 patients chemotherapy consisted of 40 to 75 mg. per m. cis-platinum intra-arterially during 30 minutes, 30 to 40 mg. per m. doxorubicin intra-arterially during 60 minutes (11 patients) or 12 hours (6 patients) and 400 to 500 mg. per m. cyclophosphamide intravenously. The remaining 8 patients received 70 to 100 mg. per m. cis-platinum intra-arterially during 30 minutes. Intra-arterial chemotherapy was administered through a percutaneous catheter placed in the hypogastric artery before each course. Courses were repeated at 4-week intervals. A total of 25 patients received 58 courses (median 2 per patient). Clinical stages of disease in the patients entering the protocol were T3aNxMo (8), T3bNx-2Mo (12) and T4a-bNxMx-1 (5). Clinical response was assessed in 24 of 25 patients: 6 achieved a complete clinical response, 12 had a partial response and 7 had no response. Of 25 patients 16 underwent total cystectomy and urinary diversion with pathological staging as follows: ToNoMo in 3, T1NoMo in 1, T3aNoMo in 5, T3bNo-2Mo in 6 and T4NoMo in 1. Intra-arterial chemotherapy can produce a complete pathological response in patients with locally advanced bladder cancer and is tolerated well by most patients.
一项I至II期研究评估了动脉内注射顺铂和阿霉素进行区域化疗作为全膀胱切除术及尿流改道术辅助治疗的效果。前17例患者的化疗方案为：动脉内注射顺铂40至75毫克/平方米，持续30分钟；动脉内注射阿霉素30至40毫克/平方米，持续60分钟（11例患者）或12小时（6例患者）；静脉注射环磷酰胺400至500毫克/平方米。其余8例患者动脉内注射顺铂70至100毫克/平方米，持续30分钟。每次疗程前，通过经皮穿刺导管将动脉内化疗药物注入腹下动脉。疗程每4周重复一次。共有25例患者接受了58个疗程（中位值为每位患者2个疗程）。进入该方案的患者疾病临床分期为T3aNxMo（8例）、T3bNx - 2Mo（12例）和T4a - bNxMx - 1（5例）。对25例患者中的24例进行了临床反应评估：6例达到完全临床缓解，12例部分缓解，7例无反应。25例患者中有16例接受了全膀胱切除术及尿流改道术，病理分期如下：T0N0M0 3例、T1N0M0 1例、T3aN0M0 5例、T3bN0 - 2M0 6例、T4N0M0 1例。动脉内化疗可使局部晚期膀胱癌患者产生完全病理反应，且大多数患者耐受性良好。
