The treatment of advanced carcinoma of the bladder with combination chemotherapy.

Thirty patients with advanced T4 transitional cell carcinoma of the bladder were treated in a prospective randomised trial with combination chemotherapy. Sixteen patients received cyclophosphamide, doxorubicin (Adriamycin) and 5-fluorouracil, whilst 14 patients received methotrexate, doxorubicin and 5-fluorouracil with folinic acid rescue. There were no complete or partial responses to either regime and there was progression in all patients. The 2 regimes were shown to be relatively non-toxic but failed to alter the natural course of the disease.