Instillation of Mitomycin C and Doxorubicin in the Prevention of Recurrent Superficial (Ta—T1) Bladder Cancer

Abstract

Both Mitomycin C (MMC) and doxorubicin (Adriamycin) (ADM) prevent the recurrence of superficial papillary (Ta-T1) urinary bladder cancers and also reduce the rate of progression. MMC appears to be more effective than ADM in buffered instillations. The number of recurrent tumours (RI/m) and the number of recurrence times (RR) before prophylactic instillation were of significant prognostic importance but the prognostic value of the grade was questionable. The buffer solution, together with methyl prednisolone, reduced the incidence of chemical cystitis.

Sequential Chemoimmunotherapy Using Mitomycin Followed by Bacillus Calmette-Guerin (MCC + BCG) Versus Single-Agent Immunotherapy (BCG) for Recurrent Superficial Bladder Tumors

“…Several studies have demonstrated the clinical safety and efficacy of intravesical chemotherapy, especially in the prevention and management of stages Ta and T1 blad der cancer [4][5][6][7]. BCG has been shown to be the most effective intravesical agent for superficial bladder carcinoma [8][9][10][11].…”

Effect of Intravesical Instillations on the Human Complement Factor H Related Protein (BTA <i>stat</i>) Test

“…Therefore, to avoid recurrences, and even progression, intravesical chemotherapy has been widely used during the past decades [5, 13]. Since 1976, immunotherapy has also provided significant possibilities in treating these patients [14].…”

“…Ten to 15% of these patients subsequently develop invasive or metastatic cancer resulting in a poor prognosis [4]. Due to this high risk for recurrences and progression in patients with superficial tumors, intravesical chemo– [5], immuno– [6] and chemoimmunotherapy [7]have been widely used. Instillation treatment usually consists of an induction course and 1–monthly [7]or 3–weekly [6]instillations thereafter.…”

Intravesical Chemotherapy (Mitomycin C) versus Immunotherapy (Bacillus Calmette-Guérin) in Superficial Bladder Cancer

“…The result of TUR alone, i.e., RR and Rl/m before ran domization, has been compared with RR and Rl/m during instillation prophylaxis. The differences between RR and Rl/m during and before the instillation period are indicators of recurrence-preventive efficacy [4,15]. The minimum follow-up period for estimation of efficacy was 6 months, anyhow, side effects were recorded from the beginning to the end.…”

“…CR, PD, disease-free interval (DFI), RR and Rl/m were used in determining the efficacy of the prophylaxis of Ta-T i cancer [4,15,16]. Each patient served as his own control when two latter end points were used.…”