The role of preoperative intra-arterial XXXX chemotherapy in combination with low-dose irradiation for @entity150 .

@entity1 @entity632 @entity5 @entity150 @entity74
Twenty @entity1 with @entity150 (T1, 3 @entity1 ; T2, 6 @entity1 ; T3, 8 @entity1 ; T4a, 3 @entity1 ) were preoperatively treated with intra-arterial @entity632 chemotherapy in combination with low-dose irradiation. The originally scheduled operations were as follows: total cystectomy in 16 @entity1 (T1 + cis, 1 @entity1 ; T2, 5 @entity1 ; T3, 7 @entity1 ; T4a, 3 @entity1 ), segmental cystectomy in 2 @entity1 , and transurethral resection in 2 @entity1 . The total dose of @entity632 ranged from 120 to 540 mg (251.5 +/- 100.2 mg), and that of irradiation was from 4 to 36 Gy (24.4 +/- 7.3 Gy). Clinical and pathological effects were evaluated in all of the cases. Clinically, complete remission (CR) was observed in 14 cases (70.0%), partial remission (PR) was seen in 3 cases, a minor response (MR) occurred in 2 cases, and no response (NR) was seen in 1 @entity1 ; non @entity1 showed @entity74 ( @entity74 ). The pathological effects (according to the criteria of Shimosato et al.) were as follows: grade IV was seen in 10 cases, grade III in 3 cases, and less than grade II in 7 cases; however, viable @entity5 cell were not seen in 13 (65.0%) of the 20 cases. The bladder was preserved in 13 (81.3%) of the 16 cases for which total cystectomy had been recommended. All of the @entity1 were followed up for periods ranging from 3 to 54 months (26.3 +/- 16.5 months), during which time 6 @entity1 (30.0%) died (3 with @entity5 , 1 without @entity5 , and 2 unknown causes). The actual survival rate according to the stage of disease was 100.0% at 50 months in T1-T2 and 40.9% at 54 months in T3-T4a. In T3-T4a, the actual survival rate in pathologically complete responders was 60% (relative rate 68.8%) at 54 months, and the actual survival rate in incomplete responders was 25.0% (relative rate 27.1%) at 36 months. The results of our study are encouraging, especially in T1-T2 and T3-T4a cases, who showed a complete response. It is concluded that @entity632 intra-arterial chemotherapy combined with low-dose irradiation could be the first treatment of choice for locally invasive @entity150 .
