H. Sekine et al., INTRAVESICAL MITOMYCIN-C AND DOXORUBICIN SEQUENTIAL THERAPY FOR CARCINOMA IN-SITU OF THE BLADDER - A LONGER FOLLOW-UP RESULT, The Journal of urology, 151(1), 1994, pp. 27-30
A total of 43 patients with carcinoma in situ of the bladder (primary
in 26 and secondary in 17) who underwent intravesical mitomycin C and
doxorubicin sequential therapy for 2 multicenter studies were followed
for a median period of 45 months (range 10 to 84). Of the patients 32
(74%) achieved complete response after induction therapy and underwen
t maintenance therapy with either mitomycin C plus doxorubicin, mitomy
cin C alone or observation only. Of the complete responders 13 (41%) h
ad a local recurrence, and subsequent repeat intravesical mitomycin C
and doxorubicin sequential therapy as well as bacillus Calmette-Guerin
was effective in a significant proportion (75% or greater). The maint
enance therapy did not have a favorable effect on the recurrence rate.
In 8 patients (19%) (3 of 32 complete responders and 5 of 11 nonrespo
nders) progression developed, including invasive cancers in 4, metasta
tic disease in 2 and both conditions in 2. Initial complete responders
had a significantly higher progression-free rate than initial nonresp
onders, although there was no difference in the sites of progression b
etween them. At the last followup 35 patients (81%) remained free of d
isease with 31 (72%) having a normally functioning bladder. According
to these results, intravesical mitomycin C and doxorubicin sequential
therapy appears to be applicable as initial treatment for carcinoma in
situ of the bladder.