Pavlotsky A, Eidelman A, Barak F, Walach N, Horn Y
Department of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel.
J Surg Oncol. 1995 Nov;60(3):191-5. doi: 10.1002/jso.2930600310.
Prophylactic intravesical chemotherapy (IVC) reduces recurrence rates of superficial transitional cell carcinoma (TCC) of the urinary bladder. The patient cohort existed of 86 individuals (stage TaN0M0 or T1N0M0) superficial carcinoma of various grades of malignancy. Following initial transuretheral resection or diagnostic cystoscopy, mitomycin C (MMC), 20 mg dissolved in 50 ml saline, was instilled intravesically by catheter over 1 hr at 2-week intervals, initially and then four more times followed by diagnostic cystoscopy (one course = 12 weeks). Two similar courses were administered thereafter for a total period of 36 weeks. For patients in remission, installations continued in monthly fractionations for 9 more months (cystoscopy every 3 months) and then at 2-month intervals for 12 more months (cystoscopy every 6 months). When cystoscopy revealed recurrence, IVC was repeated from the beginning. No symptoms of MMC-related toxicity were observed. Cystoscopic follow-up evaluations showed a complete response rate of 84% at 3 years and 81% at 5 years after initial therapy. Twenty-seven patients who had not responded to previous treatment with other drugs responded to MMC.
预防性膀胱内化疗（IVC）可降低膀胱浅表性移行细胞癌（TCC）的复发率。患者队列由86例（TaN0M0期或T1N0M0期）不同恶性程度的浅表癌患者组成。在初次经尿道切除术或诊断性膀胱镜检查后，将20mg丝裂霉素C（MMC）溶解于50ml生理盐水中，通过导管在1小时内膀胱内灌注，每2周一次，最初进行一次，然后再进行四次，随后进行诊断性膀胱镜检查（一个疗程=12周）。此后再进行两个类似疗程，为期36周。对于缓解期患者，继续每月进行一次灌注，持续9个月（每3个月进行一次膀胱镜检查），然后每2个月进行一次，持续12个月（每6个月进行一次膀胱镜检查）。当膀胱镜检查显示复发时，从一开始就重复进行IVC。未观察到与MMC相关的毒性症状。膀胱镜随访评估显示，初始治疗后3年的完全缓解率为84%，5年为81%。27例对先前其他药物治疗无反应的患者对MMC有反应。
