A COMPARISON BETWEEN INTRAVESICAL CHEMOTHERAPY AND IMMUNOTHERAPY ON SUPERFICIAL CARCINOMA OF THE BLADDER

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YARMOHAMMADI A.A.; AHMADNIA H.; EMANI M.M.

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Paper Information

Journal: MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES Year:2006 | Volume:49 | Issue:91 Page(s): 7-14

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Title

A COMPARISON BETWEEN INTRAVESICAL CHEMOTHERAPY AND IMMUNOTHERAPY ON SUPERFICIAL CARCINOMA OF THE BLADDER

Author(s)

YARMOHAMMADI A.A. | AHMADNIA H. | EMANI M.M. | Issue Writer Certificate

Keywords

TRANSITIONAL CELL CARCINOMAQ4

TURBTQ3

THIOTEPAQ3

MITOMYCIN CQ3

BCG-THERAPYQ3

Abstract

Introduction: Intravesical chemotherapy or immunotherapy is the main point in treatment of superficial TRANSITIONAL CELL CARCINOMA of bladder after performing TURBT1. But these methods have some limitations in terms of therapeutic response and the rate of complications. This study was performed to evaluate the complication rate, response to treatment and relapse of TCC2 after mixed chemotherapy with THIOTEPA and Mitomycine C in comparison with immunotherapy by BCG. Materials and Methods: In this clinical trial a total of 140 patients who admitted in urology department of Ghaem and Musa- Ebne -Jafar Hospital due to superficial TCC, were divided into 4 groups of 35. After TURBT, patients in first group were treated by THIOTEPA, on second & third group we used monotherapy with Mitomycine C, BCG, respectively. So in the last group mixed therapy with THIOTEPA plus Mitomycine C was performed.All patients in each group were followed by physical exam, lab tests (CBC, U/A) and cystoscopy every 3 months for the first 2 years, and then every 6 months until the end of study. CBC tests were performed before and after 8 weeks of every of therapy. Then gathering data was analyzed through statistical methods.Results: In this study, maximum prevalence rate of TCC was in 7 and 8 decades with an average of 66 years old. In patients there was 3.5% TIs, 43.5% stage Ta and 53% stage T1 Tumors were mostly seen in the lateral walls and the base of bladder (94%). In the group which treated with intravesical BCG, the recurrence rate of carcinoma was apparently lower than other groups and the remission's time was longer. The highest incidence rate of acute cystitis was seen in BCG-THERAPY group, while in the mixed therapy group was lowest. Hematologic and allergic side-effects were significantly lower with mixed therapy in comparison with monotherapy methods.Conclusions: Rate of recurrence in BCG-THERAPY is lower but its complications, especially acute cystitis, is common. Administration of mixed therapy has been successful in reducing complications (both systemic and local); but the therapeutic response was like the monotherapy treatment.

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