Intra-Arterial Chemotherapy with Gemcitabine and Cisplatin for Patients with Recurrence of Transitional Cell Carcinoma Confined to the Pelvis

Abstract

Post-cystectomy recurrence of transitional-cell carcinoma (TCC) that is confined to the pelvis is uncommon, and few data exist to guide its management. We used weekly intra-arterial chemotherapy with gemcitabine and cisplatin in a consecutive series of 11 patients with this diagnosis. After 2 cycles of intra-arterial chemotherapy with gemc-itabine (each cycle: 900 mg/m² on days 1, 8, and 15) plus cisplatin (each cycle: 30 mg/m² on days 1, 8, and 15), 3 patients achieved complete response (CR) and 8 patients partial response (PR). Two PR patients achieved CR after surgery and radiotherapy for residual disease. Six PR patients died of disease progression 8 to 20 months after chemotherapy. Four CR patients have survived, free of disease, 17 to 43 months, and 1 CR patient died of a non-tumor-related cause 23 months after chemotherapy. Short course intra-arterial chemotherapy with a GC regimen thus appears to be highly effective in the subset of patients with recurrent tCC confined to the pelvis.

Keywords:

• Bladder
• cystectomy
• chemotherapy
• intra-arterial chemotherapy
• transitional-cell carcinoma