A randomized pilot study of high-dose epirubicin as neoadjuvant chemotherapy in the treatment of cancer of the bilharzial bladder

• Published in: Annals of oncology Vol. 2; no. 2; p. 137
• Main Authors: Gad el Mawla, N, Mansour, M A, Eissa, S, Ali, N M, Elattar, I, Hamza, M R, Khaled, H, Habboubi, N, Magrath, I, Elsebai, I
• Format: Journal Article
• Language: English
• Published: England 01-02-1991
• Subjects: Adult; Carcinoma - drug therapy; Carcinoma - etiology; Carcinoma - mortality; Carcinoma - secondary; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - etiology; Carcinoma, Transitional Cell - drug therapy; Carcinoma, Transitional Cell - etiology; Combined Modality Therapy; Epirubicin - adverse effects; Epirubicin - therapeutic use; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Pilot Projects; Postoperative Complications; Schistosomiasis - complications; Survival Rate; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - etiology; Urinary Bladder Neoplasms - mortality
• ISSN: 0923-7534
• DOI: 10.1093/oxfordjournals.annonc.a057877

Seventy-one patients with T2 and T3 bladder cancer were randomized to receive either two courses of epirubicin 120 mg/m2 i.v. push every 21 days pre-operatively, and four additional courses post-operatively (group I = 34 patients), or radical surgery (group II = 37 patients). At a median follow-up of 24 months (range 22 months to 38 months) 25 patients from group I and 14 patients from group II are still alive and disease-free. The estimated two-year disease-free survival percentages were 73.5 and 37.9%, respectively (P = 0.05). After initial chemotherapy, resected specimens were subjected to histopathological study of chemotherapeutic effects. Necrosis was detected in 95% of cases with squamous cell carcinoma and in 57.3% of cases with transitional cell carcinoma. We conclude that the benefit which was obtained by pre-operative and post-operative chemotherapy with epirubicin is promising and may represent a significant improvement in the treatment of patients with carcinoma of the bilharzial bladder.