title: Combined intravenous and intra-arterial cyclophosphamide, doxorubicin, and cisplatin (CISCA) in the management of select patients with invasive urothelial tumors.
abstract: Twenty-eight patients with unresectable urothelial tumors who had no evidence of distant visceral metastasis were managed with iv CISCA (cyclophosphamide, doxorubicin, and cisplatin) and intra-arterial (ia) CISCA chemotherapy. Ten patients had locally advanced disease only and 18 had locally advanced disease with nodal metastasis (ten in pelvic nodes; seven in pelvic and para-aortic nodes; and one in pelvic, para-aortic, and mesenteric nodes). Eleven patients (39%) achieved a complete remission, with a median duration of 49 weeks (range, 25-108). Seven patients (25%) achieved on objective response and ten patients (36%) failed to respond. Iv and ia CISCA chemotherapy is effective in the management of advanced urothelial tumors. Patients with locally advanced disease with or without the presence of nodal metastasis are a select population in whom frequent complete remissions can be achieved.
authors.forename: C J
authors.initials: CJ
authors.lastname: Logothetis
authors.forename: M L
authors.initials: ML
authors.lastname: Samuels
authors.forename: D E
authors.initials: DE
authors.lastname: Selig
authors.forename: S
authors.initials: S
authors.lastname: Wallace
authors.forename: D E
authors.initials: DE
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002177:Candidiasis / Q000139:chemically induced; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D007261:Infusions, Intra-Arterial; D007263:Infusions, Parenteral; D007668:Kidney / Q000187:drug effects; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D014552:Urinary Tract Infections / Q000139:chemically induced
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin