Advertisement

Cancer Chemotherapy and Pharmacology

, Volume 35, Supplement 1, pp S60–S64 | Cite as

A phase II study of prophylactic intravesical chemotherapy with epirubicin in the treatment of superficial bladder cancer

  • Osamu Ryoji
  • Hiroshi Toma
  • Hayakazu Nakazawa
  • Nobuyuki Goya
  • Toshiko Okumura
  • Tokio Sonoda
  • Takeshi Kihara
  • Kazunari Tanabe
  • Sirou Onizuka
  • Hikaru Iomoe
  • Hiroshi Yanagisawa
  • Yuichiro Yamazaki
  • Fumio Ito
  • Tokyo Women's Medical College Bladder Cancer Collaborating Group
Session 3: Superficial Bladder Cancer Prophylactic Treatment, Epirubicin, Superficial Bladder Cancer
  • 24 Downloads

Abstract

Intravesical instillation of epirubicin was carried out to investigate the efficacy of this treatment in preventing postoperative recurrence of superficial bladder cancer. The subjects were 100 patients who had been treated with transurethral resection (TUR) for superficial transitional-cell carcinoma of the bladder (classified as primary or recurrent superficial bladder cancer of pathological stage Tis, Ta, or T1 and histological grade G1, G2, or G3) at Tokyo Women's Medical College Hospital and its affiliated hospitals during the 2-year period ranging from April of 1990 through March of 1992. A solution of epirubicin was prepared by dissolving 20 mg in 30 ml physiological saline, and this was instilled into the bladder a total of 17 times during 1 year: once immediately after TUR, once every 2 weeks for the next 4 months, and then once per month for the following 8 months. Thereafter, the course of each patient was followed by performing urinary cytodiagnosis once each month and cystoscopy once every 3 months. Of the 100 patients, 83 were evaluable. The mean duration of follow-up was 461±222 days, and the recurrence rate was 30.1% (25/83 cases). The recurrence rate determined for primary cases was 19.7%, whereas that recorded for recurrent cases was 61.9%. Adverse effects occurred in 9.3% (9/97) of the patients, but these side effects were mild in severity and the instillation regimen did not have to be discontinued in any of the patients. Analysis of the risk factors for recurrence revealed significantly higher recurrence in the recurrent-patient group and the multiple-tumor group. On the basis of these findings, the authors surmised that when given in an intravesical instillation regimen, epirubicin causes few adverse effects, and its efficacy in the prophylaxis of recurrence of superficial bladder cancer is equivalent to that thus for reported for other drugs. At present, the authors are carrying out a controlled clinical study on epirubicin that takes into account the risk factors for recurrence of superficial bladder cancer.

Key words

Prophylactic treatment Epirubicin Superficial bladder cancer 

References

  1. 1.
    Boyd PJR, Burnand KG (1974) Site of bladder tumor recurrence. Lancet II: 134Google Scholar
  2. 2.
    Bracken RB, Johnson DE, Rodriquez L (1977) Treatment of multiple superficial tumors of bladder with intravesical bleomycin. Urology 9: 161Google Scholar
  3. 3.
    Burnand KG, Boyd PJR, Mayo ME, Shuttleworth KED, Lloyd-Davies RW (1976) Single dose intravesical thioTEPA as an adjuvant to cystodiathermy in the treatment of transitional cell bladder carcinoma. Br J Urol 48: 55Google Scholar
  4. 4.
    Ganzina F (1983) 4′-Epi-doxorubicin, a new analogue of doxorubicin: a preliminary overview of preclinical and clinical data. Cancer Treat Rev 10: 1Google Scholar
  5. 5.
    Giuliani FC, Coirin AK, Rice MR (1981) Effect of 4′-doxorubicin analogs on heterotransplantation of human tumors in congenital athymic mice. Cancer Treat Rep 65: 1063Google Scholar
  6. 6.
    Hinman F (1960) The recurrence of bladder tumors. J Urol 83: 294Google Scholar
  7. 7.
    Matsumura Y, Ozaki Y, Ohmori H (1983) Intravesical Adriamycin chemotherapy in bladder cancer. Cancer Chemother Pharmacol 11 [Suppl]: S69Google Scholar
  8. 8.
    National Bladder Cancer Collaborative Group A (NBCCGA) (1977) Surveillance, initial assessment, and subsequent progress of patients with superficial bladder cancer in a prospective longitudinal study. Cancer Res 37: 2907Google Scholar
  9. 9.
    Niijima T, Koiso K, Akaza H, Japanese Urological Cancer Research Group for Adriamycin (1983) Randomized clinical trial on chemoprophylaxis of recurrence in cases of superficial bladder cancer. Cancer Chemother Phatmacol 11 [Suppl]: S79Google Scholar
  10. 10.
    Niijima T, Koiso K, Akaza H (1983) Randomized clinical trial for chemoprophylaxis of recurrence in superficial bladder cancer. Cancer Chemother Pharmacol 11 [Suppl]: S79Google Scholar
  11. 11.
    Prout GR Jr, Griffin PP, Nocks BN (1982) Intravesical therapy of low stage bladder carcinoma with mitocycin C: comparison of results in untreated and previously treated patients. J Urol 127: 1096Google Scholar
  12. 12.
    Soloway MS (1984) Intravesical and systemic chemotherapy in the management of superficial bladder cancer. Urol Clin North Am 11: 623Google Scholar
  13. 13.
    Tolley DA, Hargreave TB, Smith PH, Williams JL (1988) Effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer. BMJ 296: 1759Google Scholar
  14. 14.
    Tsushima T, Matsumura Y, Ozaki Y, Yoshimoto J, Obama T, Akagi T, Nasu Y, Ohmori H (1984) Intravesical chemotherapy with 4′-epi-adriamycin in patients with superficial bladder tumors. Jpn J Cancer Chemother 11: 2502Google Scholar
  15. 15.
    Veenema RJ, Dean AL Jr, Roberts M, Fingerhut B, Chowhury BK, Tarassoly H (1962) Bladder carcinoma treated by direct instillation of thio-TEPA. J Urol 88: 60Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • Osamu Ryoji
    • 1
  • Hiroshi Toma
    • 1
  • Hayakazu Nakazawa
    • 1
  • Nobuyuki Goya
    • 1
  • Toshiko Okumura
    • 2
  • Tokio Sonoda
    • 5
  • Takeshi Kihara
    • 4
  • Kazunari Tanabe
    • 3
  • Sirou Onizuka
    • 3
  • Hikaru Iomoe
    • 6
  • Hiroshi Yanagisawa
    • 7
  • Yuichiro Yamazaki
    • 1
  • Fumio Ito
    • 1
  • Tokyo Women's Medical College Bladder Cancer Collaborating Group
  1. 1.Department of UrologyTokyo Women's Medical CollegeTokyoJapan
  2. 2.Department of UrologySaiseikai Kawaguchi HospitalKawaguchiJapan
  3. 3.Department of UrologyToda Chuo HospitalTodaJapan
  4. 4.Department of UrologySaiseikai Kurihashi HospitalKurihashiJapan
  5. 5.Department of UrologyShinjuku Ishikawa HospitalIschikawaJapan
  6. 6.Department of UrologyNishiarai HospitalNishiharaJapan
  7. 7.Department of UrologyKawasaki Saiwai HospitalKawasakiJapan

Personalised recommendations