WHOLE BLADDER WALL PHOTODYNAMIC THERAPY FOR REFRACTORY CARCINOMA IN-SITU OF THE BLADDER

Whole bladder wall photodynamic therapy (PDT) with haematoporphyrin de rivative and an argon dye laser as a light source was performed on 34 patients with refractory carcinoma in situ (CIS) of the bladder. Twent y-five of the 34 patients (73.5%) had achieved a complete response. (C R) at 3 months after the treatment. The median follow-up for these CR patients is 49.3 months. Although recurrence within 2 years of follow- up occurred in 14 (77.8%) of the 18 CR patients followed to that point , since most of the recurrent tumours were superficial and low-grade p apillary tumours, transurethral resection of the bladder tumours appea red to be sufficient. Of the total of 34 patients, ten were alive with bladder intact with a mean follow-up period of 64.0 months. Skin phot osensitivity and transient decrease in bladder capacity were noted as adverse reactions, caused by retention of haematoporphyrin derivative in the skin and normal portion of the bladder. These data suggest that PDT can be an effective form of therapy for CIS of the bladder.