Sequential instillation therapy with mitomycin C and adriamycin for superficial bladder tumors


From October 1983 to September 1985, 84 patients with superficial bladder tumor (Ta, Tl, Tis) were treated with sequential instillation of mitomycin C (MMC) and adriamycin (ADM). Doses of 20 mg MMC on day 1 and 40 mg ADM on day 2 were instilled into the bladder and retained for at least 2 h; this was repeated once a week for 5 consecutive weeks. Patients who achieved complete response (CR), were randomized and underwent prophylactic treatment taking the form of either intermittent instillation of MMC or daily oral administration of 5-fluorouracil. Of 79 evaluable patients, 72 (91%) had received prior treatment for superficial bladder tumors, 69 (87%) had high-grade tumors, and 18 (23%) had non-papillary Tis. The overall response rate was 68%, made up of CR in 43 patients (54%) and partial response (PR) in 11 (14%). Patients with either five or more tumors or tumors larger than 1 cm showed a significantly lower response rate than those with fewer than five tumors and tumors smaller than 1 cm, respectively. There was no correlation between tumor growth pattern, tumor grade and response rate, though non-papillary Tis appeared to respond better than papillary tumors. A history of prior instillation therapy or of toxicity to this treatment had no significant influence on the response rate. Although no systemic toxicity was observed, 62 patients (74%) experienced cystitis and the treatment had to be discontinued within 4 weeks in 13 of 33 cases with severe symptoms. The preliminary conclusion of prophylactic treatment was that intermittent instillation of MMC was superior to 5-FU medication in reducing the recurrence rate for at least 2 years after the treatment.

DOI: 10.1007/BF00262486

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@article{Fukui1987SequentialIT, title={Sequential instillation therapy with mitomycin C and adriamycin for superficial bladder tumors}, author={Iwao Fukui and Hideaki Sekine and Kazunori Kihara and Takumi Yamada and Tsuneo Kawai and Makoto Washizuka and Daisuke Ishiwata and Kaoru Oka and Kazushige Hosoda and Shigeru Ikegami and Kunihiko Sakai and Fumio Ohwada and Takeaki Negishi and Shigeru Suzuki and Tsuguhiro Tohma and Hiroyuki Oshima}, journal={Cancer Chemotherapy and Pharmacology}, year={1987}, volume={20}, pages={S52-S55} }