Thermo-chemotherapy and electromotive drug administration of mitomycin C in superficial bladder cancer eradication - A pilot study on marker lesion

Objective: To assess the feasibility and safety of two novel methods for in travesical chemotherapy administration in patients suffering from superfici al bladder carcinomas. To draw preliminary considerations concerning the ab lative effect on marker lesion using novel approaches compared to standard intravesical chemotherapy. Methods: Eighty patients suffering from single, recurrent, low-stage, low-g rade superficial bladder tumor entered a prospective nonrandomized study. T hirty-six of them were treated by means of mitomycin C instillation as a st andard procedure. In 29 patients mitomycin C solution was administered in c ombination with local microwave-induced hyperthermia and in 15 patients the mitomycin C solution was administered according to the electromotive drug procedure. The treatment was scheduled as a short term neo-adjuvant regimen prior to transurethral resection. Feasibility and safety of the different procedures were evaluated on an outpatients basis. The local toxicity induc ed by different approaches was defined and compared using a subjective ques tionnaire. Results: Both intravesical chemotherapy administered in combination with hy perthermia and according to the electromotive drug technique appeared to be feasible and safe. Local toxicity induced by thermo-chemotherapy was more severe than that registered for electromotive drug technique and standard i ntravesical chemotherapy. Local toxicity was always short and self healing without early or delayed major complications. A higher complete response ra te on marker lesion was observed after thermo-chemotherapy compared to othe r administration methods. Conclusion: The intravesical administration of mitomycin C can be safely pe rformed in the form of both thermo-chemotherapy and electromotive drug appr oach with an increased ablative success rate on small superficial tumor inv olving only minimal local side effects. Copyright (C) 2001 S. Karger AG, Ba sel.