Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential

Article Article scientifique Article Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential eng 2000 author Roth Arnaud 134504 author Berney Christophe Roger Yves 32909 author Rohner Stéphane 69636 author Allal Abdelkarim Said 130470 author Morel Philippe 22337 author Marti Marc-Claude 21987 author Aapro M author Alberto Pierre 25242 1637-1642 10.1054/bjoc.2000.1525 11104558 0007-0920 The prognosis of locally advanced or recurrent carcinomas of the penis (PE) and of the anal canal (AC) after conventional treatment is dismal. We report 16 patients (eight with AC carcinomas and eight with PE cancers) treated by intra-arterial (IA) chemotherapy. Fifteen of them were treated for locally advanced or recurrent disease and one in an adjuvant setting. The chemotherapy was administered via a femoral IA catheter with its tip located above the aortic bifurcation, under the inferior mesenteric artery. It consisted of eight push injections, given over a 48-h period, of the following drug combination: cisplatin 8.5 mg m(-2), 5-FU 275 mg m(-2), methotrexate 27.5 mg m(-2), mitomycin C 1.2 mg m(-2), and bleomycin 4 mg m(-2). Leucovorin was given po, 4 x 15 mg day(-1), during the chemotherapy and for 3 days thereafter. A total of 52 cycles of treatment were administered. Of the 15 patients evaluable for response, six obtained a CR (three PE, three AC) and eight a PR. Among the complete responders, four are alive and disease-free 2-15 years after treatment. The other patients enjoyed an objective response lasting 3-25 months (median 7 months). Four patients developed grade III/IV haematological toxicity with three episodes of febrile neutropenia, one of them with a fatal outcome due to patient's failure to obtain medical attention at the onset of his fever, one a grade III mucositis of the glans, and four a grade III/IV cutaneous toxicity, the latter caused by the IA administration of bleomycin. In conclusion, IA chemotherapy is effective and potentially curative in locoregionally advanced or recurrent carcinomas of the penis and of the anus. Its contribution in the primary management of advanced penile or anal carcinoma should be prospectively investigated. Administration, Oral Aged Aged, 80 and over Antineoplastic Agents/adverse effects/therapeutic use Anus Neoplasms/drug therapy Arteries Bleomycin/administration & dosage/adverse effects Cisplatin/administration & dosage/adverse effects Fluorouracil/administration & dosage/adverse effects Follow-Up Studies Humans Injections Male Methotrexate/administration & dosage/adverse effects Middle Aged Mitomycin/administration & dosage/adverse effects Neoplasm Recurrence, Local Neutropenia/chemically induced Penile Neoplasms/drug therapy Skin Diseases/chemically induced Treatment Outcome Dewey 616 Dewey 616.0757 Dewey 617 56 Département de médecine 221 57 Département de chirurgie 222 62 Département de radiologie et informatique médicale 227 false 79 Chirurgie viscérale 104 1329 Chirurgie viscérale (HUG) 81 Groupe Iselin Christophe (urologie) 106 223 Groupe Roth Arnaud (oncologie) 285 British journal of cancer 83 12 58c89974-e08b-46c8-910f-4a76cea2c6a7 Article (Published version) Public 6691525a.pdf 199842 application/pdf openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale

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Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential	British journal of cancer			2000	889	280

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Berney, Christophe Roger Yves