Intermittent intra-arterial chemotherapy for the treatment of patients with bladder cancer or prostate cancer using implantable injection pump

Abstract

(Background) The objective of this study is to evaluate the usefulness of intra-arterial chemotherapy using an implantable injection system for the treatment of bladder or prostate cancer. (Methods) Twenty-four patients with bladder cancer and 13 with prostate cancer were treated with intermittent intra-arterial chemotherapy using a totally implantable injection pump. A heparinized catheter was percutaneously fixed through the femoral artery with the tip 2 or 3 cm above the bifurcation of the common iliac artery, and the pump was placed in a subcutaneous pocket. (Results) The total number of infusion sessions for bladder cancer ranged from 4 to 38 times (mean 20.8), and 15 of the 24 patients were injected from 2 to 19 sessions (mean 8.5) as outpatients. The tumor response for 15 patients with newly diagnosis muscle- invasive bladder cancer were 12 patients in CR, 1 in PR, and 2 in NC, and 9 patients with recurrent bladder cancer were 6 patients in CR, 1 in PR, and 2 in NC. The total number of infusions for prostate cancer ranged from 6 to 35 times (mean 20.2), and 10 of the 13 patients were injected from 1 to 11 times (mean 6.3) as outpatients. All 13 patients with prostate cancer were treated with hormone therapy and irradiation, and achieved PR. Complications of this drug delivery system were obstruction of the catheter or pump observed in 7 patients, dislocation of the catheter in 2, and obstruction of right external iliac artery in 1. (Conclusion) These findings suggest that favorable therapeutic efficacies and an improved quality of life for patients can be obtained by intra-arterial chemotherapy using an implantable injection pump.