[Topical chemoprophylaxis with adriamycin for superficial bladder carcinoma. Clinical and experimental aspects (author's transl)].

Topical instillation of adriamycin for treatment of superficial bladder carcinomas is of little value (complete response less than 40%) in comparison to transurethral resection. Instillation therapy may be indicated in carcinoma in situ (objective response about 70%). Value of topical chemoprophylaxis is not proven in prospective randomized clinical studies up to now. Chemical cystitis is described as local side effect in about 40%, systemic side effects are not expected. Effectiveness of instillation therapy in BBN-induced tumors in the rat can be shown 2 and 8 weeks but not 5 month after the last instillation. Instillation therapy leeds to severe dysplasia and epithelial proliferation in the normal rat mucosa. Up to now topical instillation therapy with adriamycin is indicated in carcinoma in situ (therapeutic) and in multiple, recurrent or poorly differentiated T1 carcinomas (prophylactic).