A Longitudinal Study of Patients with Superficial Bladder Carcinoma Successfully Treated with Weekly Intravesical Thio-TEPA

Abstract

Further results of a prospective clinical investigation to determine the effect of weekly intravesical bladder instillation of thio-tepa in the treatment of superficial bladder cancer is reported. Patients with superficial bladder carcinoma were treated according to 2 protocols. The 1st protocol consisted of patients with persistent tumor who were treated with weekly thio-tepa for 8 wk. Of the 33 patients 18 responded to this therapy, and they and 24 other patients who were rendered free of tumor by transurethral resection alone were assigned to the 2nd protocol in which patients were treated with monthly instillations of thio-tepa or they were observed every 3 mo. in a prescribed fashion. Monthly thio-tepa instillations had no significant effect in lowering the recurrence rate in either group. In the patients who had responded to weekly thio-tepa the following benefits were noted: fewer recurrences, with 8 of 18 (44%) previously pre-treated patients having a recurrence vs. 19 of 24 patients (79%) previously untreated; delay in tumor recurrence with an interval free of tumor of 15.1 mo. in pre-treated patients vs. 4.3 mo. in the untreated group; and diminished frequency of new tumors (0.33 recurrences/yr) in comparison to the untreated group (1.78 recurrences/yr). The remaining patients were free of tumors at 15.7 mo. average followup.