Novel bladder preservation therapy with Osaka medical college regimen

Haruhito Azuma, Teruo Inamoto, Kiyoshi Takahara, Hayahito Nomi, Hajime Hirano, Naokazu Ibuki, Hiroshi Uehara, Kazumasa Komura, Koichiro Minami, Taizo Uchimoto, Kenkichi Saito, Tomoaki Takai, Naoki Tanda, Kazuhiro Yamamoto, Yoshihumi Narumi, Satoshi Kiyama

研究成果: Article

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Purpose We investigated the effect of balloon occluded arterial infusion of an anticancer agent (cisplatin/gemcitabine), used concomitantly with hemodialysis, which delivers an extremely high concentration of anticancer agent to the tumor site without systemic adverse effects, along with concurrent radiation (referred to as the Osaka Medical College regimen) in patients with advanced bladder cancer. Materials and Methods A total of 329 patients (TisN0 16, T2N0 174, T3N0 77, T4N0 22 and TxN+ 40) were assigned to receive the Osaka Medical College regimen. Patients who did not achieve complete response underwent total cystectomy or secondary balloon occluded arterial infusion with an increased amount of cisplatin and/or gemcitabine. Results The Osaka Medical College regimen allowed 83.6% (276 of 329) of patients in total and 93.6% (250 of 267) of patients with organ confined disease (including T3b) to achieve complete response. Of the patients with a complete response 96% (240 of 250) survived with a functional bladder without evidence of recurrent disease within a mean followup of 159 weeks. Although lymph node involvement, especially N2 stage, was selected as a significant risk factor for treatment failure and survival, it was noteworthy that 61.9% of patients with N1 disease achieved complete response and that the 5-year overall survival rate was 72.2%. No patients had grade III or more severe toxicities. Conclusions The Osaka Medical College regimen, a new bladder preservation strategy, can be curative not only in patients for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment because of disease stage, age or other factors, and for whom merely palliative therapy would otherwise seem the only option.

元の言語English
ページ(範囲)443-450
ページ数8
ジャーナルJournal of Urology
193
発行部数2
DOI
出版物ステータスPublished - 01-02-2015

    フィンガープリント

All Science Journal Classification (ASJC) codes

  • Urology

これを引用

Azuma, H., Inamoto, T., Takahara, K., Nomi, H., Hirano, H., Ibuki, N., Uehara, H., Komura, K., Minami, K., Uchimoto, T., Saito, K., Takai, T., Tanda, N., Yamamoto, K., Narumi, Y., & Kiyama, S. (2015). Novel bladder preservation therapy with Osaka medical college regimen. Journal of Urology, 193(2), 443-450. https://doi.org/10.1016/j.juro.2014.08.094