Transcatheter intraarterial infusion of chemotherapy in advanced bladder cancer

Bilateral internal iliac artery infusion of chemotherapeutic agents in patients with advanced bladder carcinoma, Stage D, resulted in a 50% response or greater in nine of 15 patients with a median survival, thus far, of 52 weeks. Hematuria was controlled in eight of ten patients, and pain was relieved in 12 of 15 patients. Three additional patients were treated as adjuvants after their residual tumor was removed surgically or irradiated before chemotherapy. Cis-diamminedichloroplatinum (CDDP) was infused at a dose of 80--120 mg/m2 over a 24-hour period. When CDDP failed or in the presence of impaired renal function, a combination of 5-fluorouracil (5-FU) infused intraarterially while Adriamycin and mitomycin C were delivered intravenously, salvaged two patients. Complications were tolerable, consisting of transient acute tubular necrosis in two patients, a lower extremity embolus in one, and skin reactions due to 5-FU in two patients.