Effectiveness of Neoadjuvant and Adjuvant Bladder Intracavitary Hyperthermic Perfusion Chemotherapy (BHPC) on High-risk Non-muscle-invasive Bladder Cancer Patients

Abstract

Objective To analyze the effectiveness of neoadjuvant and adjuvant bladder intracavitary hyperthermic perfusion chemotherapy (BHPC) on high-risk non-muscle-invasive bladder cancer (NMIBC) patients. Methods We included 40 patients with high-risk NMIBC who received BHPC treatment with a "BR-TRG-Ⅱ type high-precision hyperthermic intraperitoneal perfusion treatment system" before or after transurethral resection of the bladder tumor(TURBT). Among these patients, 16 patients received neoadjuvant BHPC treatment (gemcitabine 1000 mg three instillations every other day, 45℃, 45min) before TURBT (neoadjuvant group) and 24 patients received adjuvant BHPC treatment (gemcitabine 1000 mg three instillations every other day, 45℃, 45min) after TURBT (adjuvant group). Disease recurrence free survivals (RFS) and adverse effects were evaluated between both groups. Results A total of 40 patients completed three times of gemcitabine therapy. In neoadjuvant group, 11 patients (68.8%) showed a complete response (pT0) and 5 patients (32.2%) showed a partial response. The median RFS was 54 months. In adjuvant group, the median RFS was 45 months. The difference of survival rate between them was not statistically significant (P=0.3146). The incidence and severity of side effects were mild in both two groups. Conclusion BHPC on high-risk NMIBC patients using a "BR-TRG-Ⅱ type high-precision hyperthermic intraperitoneal perfusion treatment system" is safe and effective in both neoadjuvant and adjuvant settings.

Keywords

• bladder cancer
• bladder intracavitary hyperthermic perfusion chemotherapy
• gemcitabine