Intraarterial chemoperfusion with mitoxantrone in patients with urinary bladder cancer and intratable bladder hemorrhage: comparison with intraarterial embolization.

Purpose: To assess the efficacy of intraarterial chemoperfusion (CP) with m itoxantrone in patients with bleeding bladder cancer; comparison with the r esults of intraarterial embolization therapy (ET). Materials and Methods: T hirty patients with urinary bladder cancer and intractable bladder hemorrha ge were treated with intraarterial (i.a.) CP (15 patients) using Mitoxantro n 820 mg/m(2)/1-2 h) and i.a. ET (15 patients) using Histoacryl or Ethibloc . Bleeding control rate, recurrence of hemorrhage, survival rate and compli cations were evaluated. Results: Complete control of the hemorrhage was ach ieved in 14/15 and 12/15 of the patients with CP and ET, respectively. hemo rrhage stopped in CP patients after an interval of (4 to 15) 10 days, and w ithin 24 hours in ET patients. Recurrence of hemorrhage was observed in 3/1 4 of CP and 4/13 of ET patients. The survival rate was 4-5 months in both g roups. Complications were observed in ET patients only (7/22). Posttherapeu tic pain occurred significantly more often in ET patients (20/22) than in C P patients (6/31 versus 20/22). Conclusion: Intraarterial chemoperfusion us ing Mitoxantron is an effective therapy in patients with intractable urinar y bladder hemorrhage. Due to the delayed effect in CP, ET should be used in patients with life-threatening bleeding.