Faculty Collaboration Database

Continuous antegrade infusion of adriamycin as adjuvant therapy for upper tract urothelial malignancies. Urology 2000 Aug 01;56(2):216-22

Date

08/05/2000

Pubmed ID

10925081

DOI

10.1016/s0090-4295(00)00612-9

Scopus ID

2-s2.0-0033915530 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

OBJECTIVES: To evaluate the feasibility, efficacy, and toxicity of antegrade chemotherapy delivered continuously as adjuvant treatment for patients with upper tract transitional cell carcinoma.

METHODS: During a 6-year interval, 12 patients with upper tract transitional cell malignancies underwent continuous antegrade intraluminal infusion chemotherapy (CAIIC) with adriamycin. After placement of percutaneous access and surgical treatment of the primary lesion, patients received 5-day cycles of CAIIC. Patients received between two and four treatment cycles at 2-week intervals. After therapy, patients with no evidence of residual disease were then monitored long-term with retrograde pyelography and upper tract cytology.

RESULTS: Twelve patients underwent a total of 35 5-day cycles of CAIIC. No patient experienced hematologic and/or local/regional toxicity during or after drug infusion. Three patients were treated for upper tract carcinoma in situ, and 9 patients had discrete exophytic tumors. Two patients died (treatment unrelated) before a final assessment of therapeutic outcome, leaving 10 patients available for evaluation of the therapeutic response. One patient with carcinoma in situ and 5 of 7 patients with discrete upper tract tumors remained disease free after surgery and adjuvant therapy. Both patients with discrete tumors in whom therapy failed had residual gross disease after primary surgical treatment.

CONCLUSIONS: CAIIC using adriamycin was well tolerated for periods of up to 5 days over multiple cycles. Early data suggest a limited efficacy in treating patients with gross residual disease. The efficacy of this approach in preventing the recurrence of upper tract disease after surgical ablation awaits further assessment.

Author List

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MESH terms used to index this publication - Major topics in bold

Aged
Antineoplastic Agents
Carcinoma, Transitional Cell
Chemotherapy, Adjuvant
Doxorubicin
Drug Administration Schedule
Electrosurgery
Female
Humans
Instillation, Drug
Laser Therapy
Male
Nephrostomy, Percutaneous
Treatment Outcome
Urologic Neoplasms