[Intra-arterial COMPA chemotherapy for invasive bladder cancer]

We presented 12 patients with invasive bladder cancer treated by the subselective intra-arterial COMPA chemotherapy. COMPA was administered up to an average of 3.3 courses (ranged from 2 to 6 courses) every 2 or 3 weeks, consisting of cisplatin: 15 mg/M2 on days 4 and 5; vincristine (oncovin): 0.6 mg/M2 on days 1 and 2; methotrexate: 5 mg/M2 on days 2 and 3; peplomycin: 5 mg/body on days 1, 2 and 3; and adriamycin: 10 mg/M2 on day 4. These were injected through a teflon catheter the tip of which was placed just proximal to the aortic bifurcation, and another tip was led through a subcutaneous tunnel from the inguinally punctured area to the anterior chest wall. The 12 patients, 7 men and 5 women, ranged in age from 53 to 73 (mean: 67) years. Histopathologically 11 had transitional cell carcinoma and one had adenocarcinoma. Malignant gradings were grade 2 in 8 patients, and grade 3 in 4. The stagings were T2 in 3 patients, T3 in 5, T4 in 4 and only one had bony metastasis. Of the 12 patients, 10 were alive at the last follow-up with a mean duration of 36 months (range: 16 to 49). Six patients achieved a complete remission, four achieved a partial remission and two were stable. One died of ileus after 16 months and another of progression after 36 months. All the patients received post-chemotherapeutic adjunctive therapies, which were transurethral resection, partial cystectomy, radiation and/or intravesical instillation. The toxicities were not severe, but anorexia, nausea, vomiting, hair loss, numbness of fingers and/or toes, subileus, and leukopenia were noticed.(ABSTRACT TRUNCATED AT 250 WORDS)