[Locoregional chemoperfusion with mitoxantrone for palliative therapy in bleeding bladder cancer compared with embolization].
OBJECTIVE
To assess the efficacy of intraarterial chemoperfusion (CP) with mitoxantrone in patients with bleeding bladder cancer; comparison with the results of intraarterial embolization therapy (ET).


METHODS
Thirty patients with urinary bladder cancer and intractable bladder hemorrhage were treated with intraarterial (i.a.) CP (15 patients) using Mitoxantron 820 mg/m2/1-2 h) and i.a. ET (15 patients) using Histoacryl or Ethibloc. Bleeding control rate, recurrence of hemorrhage, survival rate and complications were evaluated.


RESULTS
Complete control of the hemorrhage was achieved in 14/15 and 12/15 of the patients with CP and ET, respectively. Hemorrhage stopped in CP patients after an interval of (4 to 15) 10 days, and within 24 hours in ET patients. Recurrence of hemorrhage was observed in 3/14 of CP and 4/13 of ET patients. The survival rate was 4-5 months in both groups. Complications were observed in ET patients only (7/22). Posttherapeutic pain occurred significantly more often in ET patients (20/22) than in CP patients (6/31 versus 20/22).


CONCLUSIONS
Intra-arterial chemoperfusion using Mitoxantron is an effective therapy in patients with intractable urinary bladder hemorrhage. Due to the delayed effect in CP, ET should be used in patients with life-threatening bleeding.
Textor
H J
HJ
Radiologische Universitätsklinik Bonn.
Wilhelm
K
K
Strunk
H
H
Layer
G
G
Dölitzsch
C
C
Schild
H H
HH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000627:therapeutic use*; D010166:Palliative Care; D010477:Perfusion; D012008:Recurrence; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*
D000970:Antineoplastic Agents; D008942:Mitoxantrone
Lokoregionäre Chemoperfusion mit Mitoxantron zur palliativen Therapie blutender Blasenkarzinome im Vergleich zur Embolisation.