Intra-arterial chemotherapy of infiltrative bladder carcinoma

Twenty patients with untreated invasive high stage or high grade transitional cell carcinoma of the bladder have been treated by bilateral intra-arterial hypogastric injection of adriamycin. A total of 160 mg of adriamycin were injected during the procedure which was repeated once 3-4 weeks later. Eleven patients received two full courses of chemotherapy. In 4 patients, complete response with disappearance of all tumoral lesions was observed and in 1 patient, partial tumor regression was apparent. One patient died from pulmonary disease. Five patients received only a partial treatment because of technical difficulties, and selective catheterization was impossible in 4 because of severe arteriosclerotic lesions. No response was seen in those cases. Although this new therapeutic modality remains to be fully evaluated, preliminary results appear most encouraging since intra-arterial chemotherapy can be used safely and is effective in patients with invasive bladder carcinoma.