INTRAVESICAL MITOXANTRONE FOR SUPERFICIAL BLADDER-TUMORS

Thirty-five patients (33 males, median age 58) with stage Talpha (21 p atients) or T1, grade 1 (17 patients) or grade 2 superficial bladder c arcinoma, were treated with transurethral resection (TUR) followed by intravesical prophylactic therapy with 10 mg mitoxantrone administered weekly for 6 weeks and then monthly for 10 months. Twenty-five patien ts were newly diagnosed and 10 had relapsed after previous therapy. Di agnosis was confirmed with cytology and biopsy. The aim of the study w as to evaluate the prophylactic effect (relapse rate, disease free int erval) and toxicity of intravesical mitoxantrone in superficial bladde r carcinoma. Relapses were established with biopsy. After a mean perio d of 12 months follow-up (median 8.3 months), 63% of patients in the w hole group, 72% in the newly diagnosed group and 40% in the group of p reviously relapsed patients remained relapse free. These rates compare very favorably with the most effective prophylactic agents available. At the end of the follow-up period the median disease-free survival f or the whole group was not reached. Therapy was well tolerated with no systemic toxicity and 14 patients reporting grade 1-2 local toxicity. In no patient was treatment discontinued due to toxicity. Mitoxantron e is an effective and safe agent for the post-TUR adjuvant intravesica l therapy.