Open Access

Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer

  • Authors:
    • Haruhito Azuma
    • Teruo Inamoto
    • Naokazu Ibuki
    • Takanobu Ubai
    • Yatsugu Kotake
    • Kiyoshi Takahara
    • Satoshi Kiyama
    • Hayahito Nomi
    • Hiroshi Uehara
    • Kazumasa Komura
    • Kazuhiro Yamamoto
    • Yoshihumi Narumi
    • Yoji Katsuoka
  • View Affiliations

  • Published online on: January 1, 2011     https://doi.org/10.3892/ijo_00000819
  • Pages: 13-24
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Abstract

In this study, we investigated the novel bladder preservation therapy, the balloon-occluded arterial infusion (BOAI) of cisplatin/gemcitabine, concomitantly with hemodialysis, along with concurrent irradiation [the ‘Osaka Medical College (OMC)-regimen’] in patients >70 years of age with muscle-invasive bladder cancer. Eighty-three such patients were assigned to receive either the OMC-regimen (n=56) or cystectomy (n=27). The OMC-regimen patients who failed to achieve complete response (CR) underwent cystectomy, or secondary BOAI with gemcitabine (1600 mg). The OMC-regimen, which delivers an extremely high concentration of anti-cancer agent to the tumor site without systemic adverse effects, yielded CR in >90% (39/43) of patients with locally invasive tumors [70% (39/56) of all patients including those with T4 and N+ disease]. None of the CR patients showed recurrence after a mean follow-up of 162 (range, 35-683) weeks, and 2 patients died of unrelated causes. The 5- and 12-year overall survival rates were 92.7 and 69.5% (vs. 59.6 and 20.9% for cystectomy; P<0.0092), respectively, although the median age in the OMC-regimen group was significantly greater than that in the cystectomy group (median, 77; range, 70-98; vs. 74; 70-79; p<0.0001). No patients suffered grade III or more severe toxicities. The oldest patient, aged 98 years, successfully completed this therapy. The OMC-regimen is a useful bladder preservation strategy for elderly patients with locally invasive bladder cancer, not only for those for whom cystectomy has been indicated, but also for patients whose condition is not amenable to curative treatment and for whom palliation would otherwise seem the only option.

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January 2011
Volume 38 Issue 1

Print ISSN: 1019-6439
Online ISSN:1791-2423

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APA
Azuma, H., Inamoto, T., Ibuki, N., Ubai, T., Kotake, Y., Takahara, K. ... Katsuoka, Y. (2011). Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer. International Journal of Oncology, 38, 13-24. https://doi.org/10.3892/ijo_00000819
MLA
Azuma, H., Inamoto, T., Ibuki, N., Ubai, T., Kotake, Y., Takahara, K., Kiyama, S., Nomi, H., Uehara, H., Komura, K., Yamamoto, K., Narumi, Y., Katsuoka, Y."Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer". International Journal of Oncology 38.1 (2011): 13-24.
Chicago
Azuma, H., Inamoto, T., Ibuki, N., Ubai, T., Kotake, Y., Takahara, K., Kiyama, S., Nomi, H., Uehara, H., Komura, K., Yamamoto, K., Narumi, Y., Katsuoka, Y."Utility of the novel bladder preservation therapy, BOAI-CDDP-radiation (OMC-regimen), for elderly patients with invasive bladder cancer". International Journal of Oncology 38, no. 1 (2011): 13-24. https://doi.org/10.3892/ijo_00000819