Clinical results of intravesical instillation with MMC and BCG for the prevention of postoperative recurrence of bladder tumor
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Purpose:To investigate the clinical results of intravesical instillation with MMC and BCG for the prevention of postoperative recurrence of bladder tumor.Methods:86 cases of patients with superficial bladder cancer were included in this study. All patients received intravesical instillation of 20 mg MMC or 60mg BCG in turn once a week postoperatively, and persisted for 12 weeks. Then intravesical instillation was performed every 3 months, persisted for 2 years.Results: All patients have been followed up for 2.4 to 8 years, with a average of 4.8 years. The recurrent rate was 8.1 %.Conclusions:Intravesical instillation of MMC and BCG in turn are effective for reducing the postoperative recurrence rate of bladder tumor.Keywords:
Bladder tumor
Bladder Neoplasm
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(Purpose) We studied prophylactic intravesical instillation of mitomycin C (MMC) and pirarubicin (THP) following transurethral resection of bladder tumor (TUR-Bt) for superficial bladder cancer.(Materials and Methods) Forty-six evaluable patients were administered intravesically 20mg of MMC dissolved in 20ml saline on day 1 and 20mg of THP dissolved 20ml 5% dextrose on day 2. The patients were followed up by cystscopy and urinary cytology. Intravesical instillations were performed once a month and continued for 5 years.(Results) The non-recurrence rates at 1, 3 and 5 years were 88.8%, 79.5%and 67.0%, respectively. No significant differences were observed between grade 1-2 and 3, male and female, and solitary and multiple tumors. Although the side effects were relatively mild, 6 patients were stopped intravesical instillation.(Conclusions) Because non-recurrence rates of our report is not better than previous reports with shorter treatment periods, intravesical MMC and THP instillation for 5 years is not beneficial to the patients with superficial bladder cancer.
Pirarubicin
Mitomycin C
Bladder tumor
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Objective: To investigate the clinical results of intravesical instillation with BCG and DDP for the prevention of postoperative recurrence of bladder cancer. Method:Partial cystectomy has been carried out for 62 cases of superficial bladder tumor.All patients received intravesical instillation of 120mg BCG or 40mg DDP in turn once a week postoperatively,and persisted for 12 weeks. Then intravesical instillation was performed every 2 months persisted for 2 years. Result:All patients have been followed up for 1.5 to 6 years,The recurrent rate was 8%.Conclusion:Intravesical instillation of BCG and DDP in turn are offactuo for reducing the postoperative recurrence rate of bladder tumor.
Bladder tumor
Bladder Neoplasm
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Objective To investigate the clinical effect of intravesical instillation with GEM and BCG for prevention of postoperative recurrence of bladder tumor.Methods 85 patients with superficial bladder cancer were divided into two groups.For the chemoimmunotherapy(GEM + BCG)group,39 patients as test group received postoperative intravesical instillation of GEM(1000mg) immediately after transurethral resection of bladder tumor(TURBT)and again(2000mg)1 week later.From 2 to 7 weeks after TURBT,BCG was instilled into the bladder of all patients once weekly.Another 46 patients received postoperative intravesical instillation of 120mg BCG once a week for 7 weeks.Then all patients received in 2 travesical instillation every one mon th for 2 years.Results All patients have been followed up for 2 to 3 years,with an average of 2 years and 4 months.The recurrent rate is 10.5% in the test group and 24.2% in the control group.The effect is better in test group than in control group(P0.05).Conclusion Intravesical instillation of GEM and BCG in turn appears to be more effective for reducing postoperative recurrence rate of bladder tumor than BCG alone.
Bladder tumor
Chemoimmunotherapy
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Objective:To investigate the effects of intravesical instillation of pirarubicin(THP) to prevent postoperative recurrence of superficial bladder cancer after partial cystectomy or transurethral resection(TUR-Bt). Methods: Intravesical instillation of 30mg of THP dissolved in 50ml normal saline and retained in bladder for 30 minutes was given to the patients once a week for 8 weeks and subsequently once a month for ten months. Results: The mean follow up time was 12.3 months and the tumor recurrence rate was 12.8%. Conclusion: Intravesical instillation of THP is effective for prevention of postoperative recurrence of superficial bladder cancer with less side effect and easy to use so it can be widely used in such patients.
Pirarubicin
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Objective To evaluate intravesical instillation of mitoxantrone(MTZ) for the prevention of postoperative recurrence of bladder cancer. Methods Intravesical instillation of 12 mg MTZ dissolved in 50 ml normal saline and retained in bladder for 2 hours were given to bladder cancer patients postoperatively once a week for 8 weeks and subsequently once a month for 12 months.Kidney and liver function,blood counting,urinalysis and cystoscopy were taken periodically.The systemic and local reactions were recorded every time after the intravesical instillation. Results All of the 98 cases were followed up for 6 to 24 months with a mean of 13 months.The recurrence rate was 6.2%.There was no generalized side effect. Conclusions Intravesical instillation of MTZ was efficacious for the prevention of postoperative recurrence of superficial bladder cancer with safety and less side effect.So it can be widely used in such patients.
Mitoxantrone
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Objective To evaluate the seguential and alternate intravesical instillation of MMC BCG and THP for the prevention of bladder cancer recurrence.Methods The instillation was carrid out for 44 cases of bladder cancer after surgical management.All the patients have been followed up for 4-48 months an average of 30 months.Results The recurrence rate was 6.8%(3/44),all of them underment TURBT of TVBT.Conclusion Seguential and alternate intravesical instilation of MMC BCG and THP is an effective means of preventing bladder cancer recurrence.
Cancer recurrence
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Objective To investigate the possible mechanism and the efficacy of combined intravesical instillation of the MMC and HPC in the prophylaxis of local recurrence after resection of bladder cancer. Methods 36 patients with urinary bladder tumor were observed in the present study, 18 patients were administered with 1% HPC-MMC instilled into the urinary bladder and the other were administered conventional aqueous MMC after TURBT. The recurrence rate and side effect rate were compared in both group. Results The recurrence rate of MMC group is 33.33%(6/18), the recurrence rate of HPC-MMC group is 11.11%(2/18), the side effect rate of MMC group is 38.88%(7/18), the side effect of HPC-MMC group is 33.33%(6/18). Conclusions Combined intravesical instillation of the MMC and HPC could keep longer MMC in urine and could be effective against local recurrence of bladder cancer without additional side effects.
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Objective To investigate the efficacy and safety of immediate intravesical instillation combined with short-term maintained intravesical instillat.ion chemotherapy of pirarubicin (THP) after operation for preventing postoperative recurrence of superficial bladder tumor.Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups:group A (50 cases ) was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation,and group B (57 cases) was treated with conventional intravesical instillation chemotherapy.Patients in group A underwent intravesical instillation of THP within 24 hours,maintained intravesical instillation once a week for 8 weeks.Patients in group B underwent intravesical instillation of THP in one or two weeks after operation,once a week for 8 weeks.And then once a month for 10 months.All patients were followed up with regular cystoscopy examination.Results Patients were followed up for 13-84 months,the incidence of partial vesical toxic reaction in group A was 26.00 ％ (13/50),general symptom rate was 4.00％ ( 2/50 ),the rate of recurrency was 16.00％ ( 8/50 ).The incidence of partial vesical toxic reaction in group B was 22.81％( 13/57 ),general symptom rate was 1.75％( 1/57 ),the rate of recurrency was 19.30％ (11/57).There was no significant differences between two groups (P ＞ 0.05 ).Conclusions Immediate intravesical instillation of THP after operation is safe and effective,but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection.Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.
Key words:
Pirarubicin; Urinary bladder neoplasms; Irrigation of bladder
Pirarubicin
Perforation
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Objective To evaluate the alternate intravesical instillation of MMC and IL 2 together with BCG for the prevention of bladder cancer recurrence. Methods The instillation was carried out for 41 cases of bladder cancer after surgical management.All the patients have been followed up for 38～66 months with an average of 50 months.TNFa levels were periodically detected after the instillation. Results No recurrence has been noted in all the 34 patients of Ta,T 1 and T 2 tumors except 1 with mixed squamous cancer. 3 of 7 T 3 cases underwent TURBT,recurrence was noted in 2 and the TNFa remained much higher after the instillation. Conclusions Alternate intravesical instillation of MMC and IL 2 together with BCG is an effective means of preventing bladder cancer recurrence.TNFa detection might serve as a marker for bladder cancer recurrence.
Bladder tumor
Bladder Neoplasm
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Objective To investigate the efficacy of intravesical instillation of pirarubicin(THP) in prevention of postoperative recurrence of superficial bladder cancer after partial cystectomy or transurethral resection(TUR-Bt).Methods Intravesical instillation of 30mg of THP dissolved in 40 ml normal saline and retaining in bladder for 30 minutes was given to the patients once a week for 8 weeks and subsequently once a month for ten months.Results The mean follow up time was 6-30 months,with an average time of 12.1months.The tumor recurrence rate was 13.1%.Conclusion Intravesical instillation of THP is effective for prevention of postoperative recurrence of superficial bladder cancer with few side effect and easy to use,so it can be widely used in such patients.
Pirarubicin
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