Neoadjuvant medium-dose methotrexate, cisplatin in category T3b-T4a (N0M0) bladder cancer.
Between July 1985 and December 1988, 31 consecutive patients with category T3b-T4a (NOMO) urothelial cancer of the urinary bladder were entered into a phase II study of neoadjuvant chemotherapy with medium-dose methotrexate (300 mg/m2 followed by folinic acid rescue), cisplatin (100 mg/m2 continuous i.v. infusion) every 4 weeks for a total of 4 courses. Six patients did not respond to the first two courses of neoadjuvant chemotherapy and another 3 were considered non-responders after 4 courses. Three of these 9 patients progressed and could not undergo salvage cystectomy. Only 4 patients (13%) entered complete remission, and one of them refused surgery. All the 18 (58%) partial responders underwent radical cystectomy. The overall 2-year disease-free survival is 72%: it is 100% for the 4 complete responders, 76% for the 18 partial responders and 56% for the 9 nonresponders. A longer follow-up is necessary to evaluate the impact of the neoadjuvant chemotherapy on survival of category T3b-T4a (NOMO) bladder cancer.
Pizzocaro
G
G
Urological Oncology Division, Istituto Nazionale Tumori, Milano.
Pisani
E
E
Dormia
E
E
Piva
L
L
Maggioni
A
A
Minervini
G
G
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D015653:Cystectomy; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality
D002945:Cisplatin; D008727:Methotrexate