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document
Equivalent efficacy of mitomycin C plus doxorubicin instillation to bacillus Calmette-Guerin therapy for carcinoma in situ of the bladder . BACKGROUND To elucidate the most efficient topical therapy for carcinoma in situ of the bladder , the efficacy of intravesical mitomycin C plus doxorubicin therapy was compared with bacillus Calmette-Guerin ( BCG ) therapy . The clinical behavior of the tumor was analysed according to the histological grade . METHODS Forty-two patients with carcinoma in situ of the bladder were randomized to intravesical BCG ( 21 patients ) or mitomycin C plus doxorubicin sequential therapy ( 21 patients ) as first line treatment . The non-responders underwent the subsequent instillation of the other intravesical therapy alternately . Of the patients , 27 had grade 2 and 15 had grade 3 cancer . RESULTS Both topical therapies were equally effective with initial response rates of 86 % ( 18/21 ) for BCG and 81 % ( 17/21 ) for mitomycin C plus doxorubicin , irrespective of the tumor grade . Of seven initial non-responders , five patients achieved a complete response by subsequent instillation , resulting in a total response rate of 95 % . After a mean follow-up of 47 months , five patients ( 12 % ) developed disease progression . The progression rates were not different between the topical therapies , but were significantly higher in grade 3 than in grade 2 cases . CONCLUSION It appears likely that mitomycin C plus doxorubicin instillation has an equivalent efficacy to BCG as the initial therapy of carcinoma in situ and the combination of them would be the most efficient treatment for the disease . Moreover , histological grading would be clinically useful in defining the tumor characteristics and behavior of carcinoma in situ of the bladder .
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Intervention_Pharmacological
mitomycin C plus doxorubicin
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Intervention_Pharmacological
intravesical BCG
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Intervention_Pharmacological
mitomycin C plus doxorubicin sequential therapy
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Outcome_Other
efficacy
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Outcome_Other
response rates
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Outcome_Other
total response rate
7330
Outcome_Adverse-effects
disease progression
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Outcome_Physical
progression rates
7332
Outcome_Other
efficacy to BCG
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Participant_Condition
carcinoma