[Multidisciplinary treatment for advanced bladder cancer--a case report]

Area of Science:

• Oncology
• Cancer Therapeutics
• Medical Case Study

Background:

• Advanced bladder cancer with renal dysfunction and bilateral pulmonary metastasis presents a complex clinical challenge.
• Initial treatment involved surgical resection, port placement, and intra-arterial (IA) chemotherapy with cisplatin (CDDP).

Observation:

• Concurrent bronchial arterial infusion and radiation therapy led to significant reduction in lung metastases (63% right, 91% left).
• Docetaxel (TXT) was substituted for CDDP due to patient-reported nausea and appetite loss, with no observed adverse effects.
• Discontinuation of repeated IA chemotherapy was necessary due to neurological symptoms.

Findings:

• Multidisciplinary treatment, including IA chemotherapy, radiation, and surgery, resulted in approximately 3-year survival.
• Effective management of lung metastases was achieved, maintaining control until the patient's death.
• Subsequent metastases to the skull base and patella were managed with radiation and IA chemotherapy with angiotensin II.

Implications:

• This case demonstrates the potential efficacy of a tailored, multidisciplinary treatment strategy for advanced bladder cancer with widespread metastases.
• Intra-arterial chemotherapy, in combination with other modalities, can be a viable option for managing refractory or metastatic disease.
• Careful monitoring for adverse effects and adaptation of treatment regimens are crucial for optimizing patient outcomes and quality of life in complex cancer cases.