A randomized pilot study of high-dose epirubicin as neoadjuvant chemotherapy in the treatment of cancer of the bilharzial bladder.
Seventy-one patients with T2 and T3 bladder cancer were randomized to receive either two courses of epirubicin 120 mg/m2 i.v. push every 21 days pre-operatively, and four additional courses post-operatively (group I = 34 patients), or radical surgery (group II = 37 patients). At a median follow-up of 24 months (range 22 months to 38 months) 25 patients from group I and 14 patients from group II are still alive and disease-free. The estimated two-year disease-free survival percentages were 73.5 and 37.9%, respectively (P = 0.05). After initial chemotherapy, resected specimens were subjected to histopathological study of chemotherapeutic effects. Necrosis was detected in 95% of cases with squamous cell carcinoma and in 57.3% of cases with transitional cell carcinoma. We conclude that the benefit which was obtained by pre-operative and post-operative chemotherapy with epirubicin is promising and may represent a significant improvement in the treatment of patients with carcinoma of the bilharzial bladder.
Gad el Mawla
N
N
National Cancer Institute (NCI), Cairo, Egypt.
Mansour
M A
MA
Eissa
S
S
Ali
N M
NM
Elattar
I
I
Hamza
M R
MR
Khaled
H
H
Habboubi
N
N
Magrath
I
I
Elsebai
I
I
D000328:Adult; D002277:Carcinoma / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000209:etiology; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy / Q000209:etiology; D003131:Combined Modality Therapy; D015251:Epirubicin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010865:Pilot Projects; D011183:Postoperative Complications; D012552:Schistosomiasis / Q000150:complications*; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality
D015251:Epirubicin