New preoperative chemotherapy for bladder cancer using combination hemodialysis and direct hemoperfusion: preliminary report.
Preoperative chemotherapy and subsequent cystectomy were performed on 11 patients with locally invasive bladder cancer. Three chemotherapy regimens were tested: 1) 2 to 3 mg. per kg. doxorubicin in 5 patients, 2) 1 mg. per kg. mitomycin C in 3 and 3) 0.6 mg. per kg. mitomycin C with 70 mg. systemic bleomycin in 3. Doxorubicin and mitomycin C were infused once preoperatively into the hypogastric arteries or the aortic bifurcation, with simultaneous hemodialysis and direct hemoperfusion to remove as much extra-regional infusate as possible and, thus, reduce the systemic toxicity of the drug. Objective responses were obtained in 4 of 7 patients with measurable tumor (57 per cent). Downstaging was obtained in 7 of 11 patients (64 per cent). All patients given doxorubicin had leukocytopenia (500 to 1,900 per mm.3) and moderate patchy alopecia, and 1 patient given mitomycin C and bleomycin had thrombocytopenia (44,000 per mm.3). However, these side effects were observed comparatively less in the patients given mitomycin C only.
D000328:Adult; D000368:Aged; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D001761:Bleomycin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004285:Dogs; D004317:Doxorubicin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006464:Hemoperfusion; D006801:Humans; D007261:Infusions, Intra-Arterial; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D006435:Renal Dialysis; D013921:Thrombocytopenia / Q000139:chemically induced; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000601:surgery
D000970:Antineoplastic Agents; D008937:Mitomycins; D001761:Bleomycin; D016685:Mitomycin; D004317:Doxorubicin