ABSORPTION OF EPIRUBICIN INSTILLED INTRAVESICALLY IMMEDIATELY AFTER TRANSURETHRAL RESECTION OF SUPERFICIAL BLADDER-CANCER

As postoperative adjuvant therapy for superficial bladder cancer, intr avesical instillation therapy is commonly conducted. In this case, fro m the view point of prevention of intraoperative dissemination, commen cement of instillation therapy at an early postoperative period is pre ferred. However, increased drug permeability is suspected because of d amage to the bladder mucosa during operation. Therefore, this study wa s conducted to investigate the plasma level of epirubicin (EPI) instil led immediately after transurethral operation. EPI (20 mg/40 ml or 50 mg/100 ml) was instilled immediately after a transurethral operation, and retained in the bladder for 1 h. Blood samples were obtained befor e instillation, as well as 30, 60, 120 and 240 min after instillation, and EPI levels were assayed. The mean EPI concentrations (ng/ml) amon g the 20-mg/40 ml group (n = 5) were <2.5 and <2.0 at 30 and 60 min, r espectively, after which they were undetectable. The 50-mg/100 ml grou p (n = 5) recorded 5.0, 4.4 and <3.0 after 30, 60 and 120 min, respect ively, and after 240 min it was undetectable. Intravesical instillatio n of EPI immediately after a transurethral operation causes a small in crease in the plasma level and it is thought to cause small systemic s ide effects.