HYPERTHERMIC INTRAVESICAL PEPLOMYCIN PERFUSION TREATMENT FOR BLADDER-CANCER

Thirty-three patients with malignant bladder tumours were treated by h yperthermic intravesical perfusion. The study group included 25 patien ts with superficial T1 bladder tumours, 4 with T2 tumours and 4 with T 3 tumours. Physiological saline solution containing 40 mug/ml peplomyc in with/without 2% ethanol was used as a perfusate. Perfusion was carr ied out for 2 h 3 times per week and this regimen was repeated every o ther week, totalling 6 sessions in 3 weeks. Three patients achieved a complete response (CR), 5 a partial response (PR) (more than 50% tumou r reduction), 8 a minimal response (MR) (25-50% tumour reduction) and the remaining 17 patients showed no response (NC). Complete, partial a nd minimal responses were obtained only in patients with T1 tumours. T he NC patients included 4 with T2 and 4 with T3 lesions. Profuse haema turia from invasive tumour was markedly reduced after treatment. A maj or side effect was irritation of the bladder and urethra. Our results indicate that hyperthermic perfusion with ethanol and peplomycin is cl inically safe, is accompanied by very little pain and may be useful fo r the management of superficial bladder tumours in elderly patients.