Intra-arterial infusion of chemotherapy in the treatment of penile cancer

Abstract

Objective: Patients with penile cancer sometimes refuse surgery under the consideration of cosmetic and functional impact. The efficacy of intra-arterial (IA) chemotherapy for penile cancer has not been well defined. Methods: Five patients with penile cancer, receiving at least two courses of IA chemotherapy, were analyzed from January 2005 to January 2009. These patients all refused surgery initially. The drug combinations were as follows: methotrexate, mitomycin C, bleomycin, cisplatin and 5-fluorouracil. Carboplatin was used instead of cisplatin for one patient with renal insufficiency. Results: The overall response rate (complete or partial) was 100%. One case achieved complete remission and four cases achieved partial remission. Among the partial responders, three cases underwent subsequent partial penectomy to preserve partial appearance. Mild (Grades I-II) anorexia is the most common adverse effect of IA chemotherapy. Hematological toxicity included two episodes of Grade III anemia and one episode of Grade III febrile neutropenia. Conclusions: Organ- and function-sparing approaches are proposed using combination therapies, especially for those with huge tumor burden. Our preliminary data indicated that a combination of IA neoadjuvant chemotherapy and surgery may have the potential to achieve the goal in the treatment of penile cancer with negative lymph node. © The Author (2009). Published by Oxford University Press. All rights reserved.