A great option for elderly patients with locally invasive bladder cancer, BOAI-CDDP-radiation (OMC regimen)

Haruhito Azuma, Teruo Inamoto, Kiyoshi Takahara, Hayahito Nomi, Hajime Hirano, Hiroshi Uehara, Kazumasa Komura, Koichiro Minami, Junko Kouno, Yatsugu Kotake, Hirokazu Abe, Shizuko Takagi, Naokazu Ibuki, Kazuhiro Yamamoto, Yoshihumi Narumi, Satoshi Kiyama

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

We have developed a novel bladder preservation therapy, balloon-occluded arterial infusion (BOAI) of cisplatin/gemcitabine, concomitantly with hemodialysis, along with concurrent irradiation [the so-called 'OMC (Osaka Medical College) regimen']. The OMC regimen delivers an extremely high concentration of anticancer agent to the site of a tumor without systemic adverse effects, since more than 95% of free Pt was efficiently eliminated by hemodialysis, which enables short hospital stay. In this study, we investigated the efficiency of OMC regimen in patients aged over 70 years with muscle invasive bladder cancer without metastasis. A total of 134 such patients were assigned to receive either the OMC regimen (n=89) or cystectomy (n=45). OMC regimen patients who failed to achieve CR underwent cystectomy, or secondary BOAI with gemcitabine (1,600 mg). The OMC regimen, which delivers an extremely high concentration of anticancer agent to the tumor site without systemic adverse effects, yielded CR in >91% (81/89) of patients. More than 96% (78/81) of the CR patients survived without recurrence with intact bladder after a mean follow-up of 164 (range 16-818) weeks. The 5-and 10-year bladder intact survival rates were 87.2 and 69.8%, and overall survival rates were 88.4 and 70.7% (vs. 59.9 and 33.3% for cystectomy, p=0.0002), respectively, although the median age in the OMC regimen group was significantly greater than in the cystectomy group (median, range = 77, 70-98 vs. 74, 70-89; p=0.0003). No patients suffered grade II or more severe toxicities; the oldest patient, aged 91 years, successfully completed this therapy. In conclusion, the OMC regimen is a useful bladder preservation strategy for elderly patients with locally invasive bladder cancer, not only in those for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment and for whom palliation would otherwise seem the only option.

Original languageEnglish
Pages (from-to)1087-1094
Number of pages8
JournalInternational Journal of Oncology
Volume43
Issue number4
DOIs
Publication statusPublished - 01-10-2013

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Urinary Bladder Neoplasms
Radiation
Cystectomy
gemcitabine
Urinary Bladder
Antineoplastic Agents
Renal Dialysis
Survival Rate
Cisplatin
Length of Stay
Neoplasms
Therapeutics
Neoplasm Metastasis
Recurrence
Muscles

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Azuma, Haruhito ; Inamoto, Teruo ; Takahara, Kiyoshi ; Nomi, Hayahito ; Hirano, Hajime ; Uehara, Hiroshi ; Komura, Kazumasa ; Minami, Koichiro ; Kouno, Junko ; Kotake, Yatsugu ; Abe, Hirokazu ; Takagi, Shizuko ; Ibuki, Naokazu ; Yamamoto, Kazuhiro ; Narumi, Yoshihumi ; Kiyama, Satoshi. / A great option for elderly patients with locally invasive bladder cancer, BOAI-CDDP-radiation (OMC regimen). In: International Journal of Oncology. 2013 ; Vol. 43, No. 4. pp. 1087-1094.
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abstract = "We have developed a novel bladder preservation therapy, balloon-occluded arterial infusion (BOAI) of cisplatin/gemcitabine, concomitantly with hemodialysis, along with concurrent irradiation [the so-called 'OMC (Osaka Medical College) regimen']. The OMC regimen delivers an extremely high concentration of anticancer agent to the site of a tumor without systemic adverse effects, since more than 95{\%} of free Pt was efficiently eliminated by hemodialysis, which enables short hospital stay. In this study, we investigated the efficiency of OMC regimen in patients aged over 70 years with muscle invasive bladder cancer without metastasis. A total of 134 such patients were assigned to receive either the OMC regimen (n=89) or cystectomy (n=45). OMC regimen patients who failed to achieve CR underwent cystectomy, or secondary BOAI with gemcitabine (1,600 mg). The OMC regimen, which delivers an extremely high concentration of anticancer agent to the tumor site without systemic adverse effects, yielded CR in >91{\%} (81/89) of patients. More than 96{\%} (78/81) of the CR patients survived without recurrence with intact bladder after a mean follow-up of 164 (range 16-818) weeks. The 5-and 10-year bladder intact survival rates were 87.2 and 69.8{\%}, and overall survival rates were 88.4 and 70.7{\%} (vs. 59.9 and 33.3{\%} for cystectomy, p=0.0002), respectively, although the median age in the OMC regimen group was significantly greater than in the cystectomy group (median, range = 77, 70-98 vs. 74, 70-89; p=0.0003). No patients suffered grade II or more severe toxicities; the oldest patient, aged 91 years, successfully completed this therapy. In conclusion, the OMC regimen is a useful bladder preservation strategy for elderly patients with locally invasive bladder cancer, not only in those for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment and for whom palliation would otherwise seem the only option.",
author = "Haruhito Azuma and Teruo Inamoto and Kiyoshi Takahara and Hayahito Nomi and Hajime Hirano and Hiroshi Uehara and Kazumasa Komura and Koichiro Minami and Junko Kouno and Yatsugu Kotake and Hirokazu Abe and Shizuko Takagi and Naokazu Ibuki and Kazuhiro Yamamoto and Yoshihumi Narumi and Satoshi Kiyama",
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Azuma, H, Inamoto, T, Takahara, K, Nomi, H, Hirano, H, Uehara, H, Komura, K, Minami, K, Kouno, J, Kotake, Y, Abe, H, Takagi, S, Ibuki, N, Yamamoto, K, Narumi, Y & Kiyama, S 2013, 'A great option for elderly patients with locally invasive bladder cancer, BOAI-CDDP-radiation (OMC regimen)', International Journal of Oncology, vol. 43, no. 4, pp. 1087-1094. https://doi.org/10.3892/ijo.2013.2058

A great option for elderly patients with locally invasive bladder cancer, BOAI-CDDP-radiation (OMC regimen). / Azuma, Haruhito; Inamoto, Teruo; Takahara, Kiyoshi; Nomi, Hayahito; Hirano, Hajime; Uehara, Hiroshi; Komura, Kazumasa; Minami, Koichiro; Kouno, Junko; Kotake, Yatsugu; Abe, Hirokazu; Takagi, Shizuko; Ibuki, Naokazu; Yamamoto, Kazuhiro; Narumi, Yoshihumi; Kiyama, Satoshi.

In: International Journal of Oncology, Vol. 43, No. 4, 01.10.2013, p. 1087-1094.

Research output: Contribution to journalArticle

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T1 - A great option for elderly patients with locally invasive bladder cancer, BOAI-CDDP-radiation (OMC regimen)

AU - Azuma, Haruhito

AU - Inamoto, Teruo

AU - Takahara, Kiyoshi

AU - Nomi, Hayahito

AU - Hirano, Hajime

AU - Uehara, Hiroshi

AU - Komura, Kazumasa

AU - Minami, Koichiro

AU - Kouno, Junko

AU - Kotake, Yatsugu

AU - Abe, Hirokazu

AU - Takagi, Shizuko

AU - Ibuki, Naokazu

AU - Yamamoto, Kazuhiro

AU - Narumi, Yoshihumi

AU - Kiyama, Satoshi

PY - 2013/10/1

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N2 - We have developed a novel bladder preservation therapy, balloon-occluded arterial infusion (BOAI) of cisplatin/gemcitabine, concomitantly with hemodialysis, along with concurrent irradiation [the so-called 'OMC (Osaka Medical College) regimen']. The OMC regimen delivers an extremely high concentration of anticancer agent to the site of a tumor without systemic adverse effects, since more than 95% of free Pt was efficiently eliminated by hemodialysis, which enables short hospital stay. In this study, we investigated the efficiency of OMC regimen in patients aged over 70 years with muscle invasive bladder cancer without metastasis. A total of 134 such patients were assigned to receive either the OMC regimen (n=89) or cystectomy (n=45). OMC regimen patients who failed to achieve CR underwent cystectomy, or secondary BOAI with gemcitabine (1,600 mg). The OMC regimen, which delivers an extremely high concentration of anticancer agent to the tumor site without systemic adverse effects, yielded CR in >91% (81/89) of patients. More than 96% (78/81) of the CR patients survived without recurrence with intact bladder after a mean follow-up of 164 (range 16-818) weeks. The 5-and 10-year bladder intact survival rates were 87.2 and 69.8%, and overall survival rates were 88.4 and 70.7% (vs. 59.9 and 33.3% for cystectomy, p=0.0002), respectively, although the median age in the OMC regimen group was significantly greater than in the cystectomy group (median, range = 77, 70-98 vs. 74, 70-89; p=0.0003). No patients suffered grade II or more severe toxicities; the oldest patient, aged 91 years, successfully completed this therapy. In conclusion, the OMC regimen is a useful bladder preservation strategy for elderly patients with locally invasive bladder cancer, not only in those for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment and for whom palliation would otherwise seem the only option.

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