Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer

Haruhito Azuma, Teruo Inamoto, Naokazu Ibuki, Takanobu Ubai, Yatsugu Kotake, Kiyoshi Takahara, Satoshi Kiyama, Hayahito Nomi, Hiroshi Uehara, Kazumasa Komura, Kazuhiro Yamamoto, Yoshihumi Narumi, Yoji Katsuoka

Research output: Contribution to journalArticle

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Abstract

In this study, we investigated the novel bladder preservation therapy, the balloon-occluded arterial infusion (BOAI) of cisplatin/gemcitabine, concomitantly with hemodialysis, along with concurrent irradiation [the 'Osaka Medical College (OMC)-regimen'] in patients >70 years of age with muscle-invasive bladder cancer. Eighty-three such patients were assigned to receive either the OMC-regimen (n=56) or cystectomy (n=27). The OMC-regimen patients who failed to achieve complete response (CR) underwent cystectomy, or secondary BOAI with gemcitabine (1600 mg). The OMCregimen, which delivers an extremely high concentration of anti-cancer agent to the tumor site without systemic adverse effects, yielded CR in >90% (39/43) of patients with locally invasive tumors [70% (39/56) of all patients including those with T4 and N + disease]. None of the CR patients showed recurrence after a mean follow-up of 162 (range, 35-683) weeks, and 2 patients died of unrelated causes. The 5- and 12-year overall survival rates were 92.7 and 69.5% (vs. 59.6 and 20.9% for cystectomy; P<0.0092), respectively, although the median age in the OMC-regimen group was significantly greater than that in the cystectomy group (median, 77; range, 70-98; vs. 74; 70-79; p<0.0001). No patients suffered grade III or more severe toxicities. The oldest patient, aged 98 years, successfully completed this therapy. The OMC-regimen is a useful bladder preservation strategy for elderly patients with locally invasive bladder cancer, not only for those for whom cystectomy has been indicated, but also for patients whose condition is not amenable to curative treatment and for whom palliation would otherwise seem the only option.

Original languageEnglish
Pages (from-to)13-24
Number of pages12
JournalInternational Journal of Oncology
Volume38
Issue number1
DOIs
Publication statusPublished - 01-01-2011

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Urinary Bladder Neoplasms
Urinary Bladder
Radiation
Cystectomy
gemcitabine
Therapeutics
Neoplasms
Cisplatin
Renal Dialysis
Survival Rate
Recurrence
Muscles

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Azuma, Haruhito ; Inamoto, Teruo ; Ibuki, Naokazu ; Ubai, Takanobu ; Kotake, Yatsugu ; Takahara, Kiyoshi ; Kiyama, Satoshi ; Nomi, Hayahito ; Uehara, Hiroshi ; Komura, Kazumasa ; Yamamoto, Kazuhiro ; Narumi, Yoshihumi ; Katsuoka, Yoji. / Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer. In: International Journal of Oncology. 2011 ; Vol. 38, No. 1. pp. 13-24.
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title = "Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer",
abstract = "In this study, we investigated the novel bladder preservation therapy, the balloon-occluded arterial infusion (BOAI) of cisplatin/gemcitabine, concomitantly with hemodialysis, along with concurrent irradiation [the 'Osaka Medical College (OMC)-regimen'] in patients >70 years of age with muscle-invasive bladder cancer. Eighty-three such patients were assigned to receive either the OMC-regimen (n=56) or cystectomy (n=27). The OMC-regimen patients who failed to achieve complete response (CR) underwent cystectomy, or secondary BOAI with gemcitabine (1600 mg). The OMCregimen, which delivers an extremely high concentration of anti-cancer agent to the tumor site without systemic adverse effects, yielded CR in >90{\%} (39/43) of patients with locally invasive tumors [70{\%} (39/56) of all patients including those with T4 and N + disease]. None of the CR patients showed recurrence after a mean follow-up of 162 (range, 35-683) weeks, and 2 patients died of unrelated causes. The 5- and 12-year overall survival rates were 92.7 and 69.5{\%} (vs. 59.6 and 20.9{\%} for cystectomy; P<0.0092), respectively, although the median age in the OMC-regimen group was significantly greater than that in the cystectomy group (median, 77; range, 70-98; vs. 74; 70-79; p<0.0001). No patients suffered grade III or more severe toxicities. The oldest patient, aged 98 years, successfully completed this therapy. The OMC-regimen is a useful bladder preservation strategy for elderly patients with locally invasive bladder cancer, not only for those for whom cystectomy has been indicated, but also for 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 Naokazu Ibuki and Takanobu Ubai and Yatsugu Kotake and Kiyoshi Takahara and Satoshi Kiyama and Hayahito Nomi and Hiroshi Uehara and Kazumasa Komura and Kazuhiro Yamamoto and Yoshihumi Narumi and Yoji Katsuoka",
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Azuma, H, Inamoto, T, Ibuki, N, Ubai, T, Kotake, Y, Takahara, K, Kiyama, S, Nomi, H, Uehara, H, Komura, K, Yamamoto, K, Narumi, Y & Katsuoka, Y 2011, 'Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer', International Journal of Oncology, vol. 38, no. 1, pp. 13-24. https://doi.org/10.3892/ijo-00000819

Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer. / Azuma, Haruhito; Inamoto, Teruo; Ibuki, Naokazu; Ubai, Takanobu; Kotake, Yatsugu; Takahara, Kiyoshi; Kiyama, Satoshi; Nomi, Hayahito; Uehara, Hiroshi; Komura, Kazumasa; Yamamoto, Kazuhiro; Narumi, Yoshihumi; Katsuoka, Yoji.

In: International Journal of Oncology, Vol. 38, No. 1, 01.01.2011, p. 13-24.

Research output: Contribution to journalArticle

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T1 - Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer

AU - Azuma, Haruhito

AU - Inamoto, Teruo

AU - Ibuki, Naokazu

AU - Ubai, Takanobu

AU - Kotake, Yatsugu

AU - Takahara, Kiyoshi

AU - Kiyama, Satoshi

AU - Nomi, Hayahito

AU - Uehara, Hiroshi

AU - Komura, Kazumasa

AU - Yamamoto, Kazuhiro

AU - Narumi, Yoshihumi

AU - Katsuoka, Yoji

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