Keyword: Cisplatin
2 results found.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A25, https://doi.org/10.63946/onmt/19309
ABSTRACT:
Background: Tumor-related bleeding in bladder cancer is a serious complication that may limit the feasibility of standard surgical treatment, particularly in patients with comorbidities. Chemoembolization of the inferior vesical arteries is a minimally invasive technique combining local administration of an antineoplastic agent with embolization of the vessels supplying the tumor.
Objective: To evaluate the outcomes of chemoembolization of the inferior vesical arteries in patients with bladder cancer complicated by bleeding.
Materials and Methods: From 2020 to November 2024, chemoembolization of the inferior vesical arteries was performed in 12 patients with bladder cancer at the State Enterprise on the Right of Economic Management “Multidisciplinary Medical Center” of the Akimat of Astana. The procedure was performed using doxorubicin (Adriamycin) at a dose of 50 mg or cisplatin at a dose of 50 mg. Treatment efficacy was assessed based on the patients’ general condition, presence of gross hematuria, changes in laboratory blood parameters, and tumor size evaluated by computed tomography, ultrasonography, and cystoscopy.
Results: At two months after chemoembolization, no episodes of gross hematuria were observed, and laboratory blood parameters showed improvement. After two chemoembolization sessions, tumor size decreased by more than 25% on average, as assessed by computed tomography, ultrasonography, and cystoscopy. Six patients underwent surgical treatment three months after the first chemoembolization procedure: transurethral resection in four patients, open bladder resection in one, and cystectomy in one. Histopathological examination of the resected tumor tissue demonstrated treatment-induced tumor necrosis. Three patients with advanced disease were referred for further chemoradiotherapy. Three patients with early-stage disease remained under surveillance with a recommendation for intravesical chemotherapy.
Conclusions: Chemoembolization of the inferior vesical arteries may be considered a minimally invasive method for controlling tumor-related bleeding in patients with bladder cancer, particularly when major surgical intervention is limited by comorbidities. The findings suggest that this approach may be promising; however, the small sample size and limited follow-up period warrant further investigation to determine the optimal number of treatment sessions and assess long-term efficacy.
Objective: To evaluate the outcomes of chemoembolization of the inferior vesical arteries in patients with bladder cancer complicated by bleeding.
Materials and Methods: From 2020 to November 2024, chemoembolization of the inferior vesical arteries was performed in 12 patients with bladder cancer at the State Enterprise on the Right of Economic Management “Multidisciplinary Medical Center” of the Akimat of Astana. The procedure was performed using doxorubicin (Adriamycin) at a dose of 50 mg or cisplatin at a dose of 50 mg. Treatment efficacy was assessed based on the patients’ general condition, presence of gross hematuria, changes in laboratory blood parameters, and tumor size evaluated by computed tomography, ultrasonography, and cystoscopy.
Results: At two months after chemoembolization, no episodes of gross hematuria were observed, and laboratory blood parameters showed improvement. After two chemoembolization sessions, tumor size decreased by more than 25% on average, as assessed by computed tomography, ultrasonography, and cystoscopy. Six patients underwent surgical treatment three months after the first chemoembolization procedure: transurethral resection in four patients, open bladder resection in one, and cystectomy in one. Histopathological examination of the resected tumor tissue demonstrated treatment-induced tumor necrosis. Three patients with advanced disease were referred for further chemoradiotherapy. Three patients with early-stage disease remained under surveillance with a recommendation for intravesical chemotherapy.
Conclusions: Chemoembolization of the inferior vesical arteries may be considered a minimally invasive method for controlling tumor-related bleeding in patients with bladder cancer, particularly when major surgical intervention is limited by comorbidities. The findings suggest that this approach may be promising; however, the small sample size and limited follow-up period warrant further investigation to determine the optimal number of treatment sessions and assess long-term efficacy.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A22, https://doi.org/10.63946/onmt/19306
ABSTRACT:
Introduction: Hyperthermic intrapleural chemotherapy combined with cytoreductive surgery is used for malignant pleural neoplasms and tumors with pleural dissemination. Anesthetic management is complicated by prolonged one-lung ventilation, surgical trauma, blood loss, fluid loading, hyperthermia, and the potential nephrotoxicity of cisplatin.
Objective: To evaluate the characteristics of anesthetic management and major perioperative complications associated with cytoreductive thoracic surgeries with hyperthermic intrapleural chemotherapy.
Materials and Methods: A retrospective analysis was conducted on 15 patients who underwent the aforementioned procedures between 2024 and 2025. General anesthesia included intubation with a double-lumen endobronchial tube and one-lung ventilation with a tidal volume of 4–6 mL/kg of ideal body weight and positive end-expiratory pressure of 5–8 cm H₂O. Non-invasive blood pressure, temperature, urine output, acid-base status, and venous blood lactate were monitored; central venous access was used. Perfusion was performed in a closed circuit at 42 °C for up to 60 minutes with cisplatin at 125 mg/m². Descriptive statistics were used.
Results: Patient age ranged from 35 to 68 years, with a mean age of 56.6 years. The median duration of anesthesia was 8 hours and 13 minutes, blood loss – 500 mL, fluid therapy – 5500 mL, and urine output – 900 mL. Respiratory and pleural complications were recorded in 9 (60.0%) patients, acute kidney injury – in 2 (13.3%); one patient required 10 sessions of hemodialysis. One case each (6.7%) of thrombotic complications and atrial fibrillation was observed. The median length of stay in the intensive care unit was 2 days. All patients were discharged from the hospital; two late deaths were recorded during follow-up.
Conclusions: Cytoreductive thoracic surgeries with hyperthermic intrapleural chemotherapy are associated with significant perioperative burden and a risk of respiratory, pleural, and renal complications. Our experience highlights the need for protective one-lung ventilation, adequate fluid and hemodynamic support, monitoring of acid-base status, temperature, and urine output, as well as early detection of renal dysfunction.
Funding: This study was financially supported by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan, Grant No. BR24992950 "Creation and implementation of innovative methods for the treatment of oncological diseases."
Objective: To evaluate the characteristics of anesthetic management and major perioperative complications associated with cytoreductive thoracic surgeries with hyperthermic intrapleural chemotherapy.
Materials and Methods: A retrospective analysis was conducted on 15 patients who underwent the aforementioned procedures between 2024 and 2025. General anesthesia included intubation with a double-lumen endobronchial tube and one-lung ventilation with a tidal volume of 4–6 mL/kg of ideal body weight and positive end-expiratory pressure of 5–8 cm H₂O. Non-invasive blood pressure, temperature, urine output, acid-base status, and venous blood lactate were monitored; central venous access was used. Perfusion was performed in a closed circuit at 42 °C for up to 60 minutes with cisplatin at 125 mg/m². Descriptive statistics were used.
Results: Patient age ranged from 35 to 68 years, with a mean age of 56.6 years. The median duration of anesthesia was 8 hours and 13 minutes, blood loss – 500 mL, fluid therapy – 5500 mL, and urine output – 900 mL. Respiratory and pleural complications were recorded in 9 (60.0%) patients, acute kidney injury – in 2 (13.3%); one patient required 10 sessions of hemodialysis. One case each (6.7%) of thrombotic complications and atrial fibrillation was observed. The median length of stay in the intensive care unit was 2 days. All patients were discharged from the hospital; two late deaths were recorded during follow-up.
Conclusions: Cytoreductive thoracic surgeries with hyperthermic intrapleural chemotherapy are associated with significant perioperative burden and a risk of respiratory, pleural, and renal complications. Our experience highlights the need for protective one-lung ventilation, adequate fluid and hemodynamic support, monitoring of acid-base status, temperature, and urine output, as well as early detection of renal dysfunction.
Funding: This study was financially supported by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan, Grant No. BR24992950 "Creation and implementation of innovative methods for the treatment of oncological diseases."