Decaestecker Karel, Lumen Nicolaas, Van Camp Christel, Oosterlinck Willem
a Department of Urology , Ghent University Hospital , Ghent , Belgium.
Acta Clin Belg. 2018 Oct;73(5):324-327. doi: 10.1080/17843286.2018.1440706. Epub 2018 Feb 16.
Objectives To explore the effect of electromotive drug administration of mitomycin C (EMDA-MMC) using a single dose of intravesical mitomycin C (MMC) to avoid transurethral resection (TURBT) for small non-muscle-invasive bladder cancer. Material and methods All patients presenting small (<2 cm), single or multiple papillary bladder tumors were proposed to undergo a single EMDA-MMC instillation with 60 mg MMC before planning TURBT. The end point is complete disappearance of all papillary tumors at 2-4 weeks after EMDA-MMC. Results Thirty-six instillations were given to 32 patients. In general the treatment was well supported, except for two patients who had severe bladder spasms, resulting in early evacuation of the MMC. Complete response occurred in 28% (10/36 instillations). In 4 EMDA-MMCs with multiple tumors some tumors disappeared while others remained. In 61% (22/36) the tumors remained unchanged. Conclusion A single EMDA-MMC in l papillary bladder tumors <2 cm gives insufficient ablative effect.
目的 探讨使用单剂量膀胱内注射丝裂霉素C(MMC)进行丝裂霉素C电动药物灌注(EMDA-MMC)以避免对小的非肌层浸润性膀胱癌进行经尿道膀胱肿瘤切除术(TURBT)的效果。材料与方法 所有表现为小的(<2 cm)、单个或多个乳头状膀胱肿瘤的患者,在计划进行TURBT之前,建议接受一次60 mg MMC的EMDA-MMC灌注。终点是EMDA-MMC后2至4周所有乳头状肿瘤完全消失。结果 对32例患者进行了36次灌注。总体而言,除两名患者出现严重膀胱痉挛导致MMC提前排出外,治疗得到良好支持。完全缓解率为28%(10/36次灌注)。在4次有多个肿瘤的EMDA-MMC灌注中,一些肿瘤消失而另一些仍存在。61%(22/36)的肿瘤无变化。结论 对<2 cm的单个乳头状膀胱肿瘤进行单次EMDA-MMC治疗的消融效果不足。