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At least 559 records · Page 31Linked to original sources
PubMed1996

The effects of thiotepa, mitomycin C, BCG and interferon instillation on urothelium.

The effects of Thiotepa, Mitomycin C, BCG and Interferon on urothelium were researched in rabbits. Early changes of a contracted bladder such as fibroblastic atypia and sub-epithelial plaque were seen in all groups in different rates. This rate in the Thiotepa and BCG groups was 100% and in the Mitomycin C and Interferon groups 60%. There was no urothelial dysplasia in the BCG and Interferon groups, whereas in the Thiotepa group 100% and in the Mitomycin C group 40% were seen. In conclusion, urothelial dysplasia or fibroblastic atypia in random biopsies were criteria to prevent further complications in intravesical therapies.

Administration, Intravesical↗
PubMed1989

Intravesical interferon treatment of superficial bladder cancer.

Superficial transitional cell carcinoma (TCC) of the bladder and carcinoma in situ (CIS) have a high recurrence rate and a variable incidence of progressive disease. Conventional intravesical agents used to treat these carcinomas have achieved only a variable degree of success, and have adverse side effects. Recently, intravesical interferon has been explored as a treatment for TCC and CIS. In a randomized, controlled trial, patients with CIS exhibited a significantly higher rate of complete response (CR) to high-dose (100 x 10(6) IU) than to low-dose (10 x 10(6) IU) interferon (45% vs 6%, respectively, p less than 0.0001). To date, 9/19 patients in the high-dose CR group have maintained a CR for at least six months. Five patients receiving high-dose therapy and 5 receiving low-dose therapy subsequently underwent cystectomy, but median time to surgery was 33.5 weeks for the high-dose group vs eighteen weeks for the low-dose group. Intravesical interferon was generally well tolerated. These results suggest that randomized clinical trials are warranted to assess the efficacy of intravesical interferon, as compared to BCG, for the treatment of CIS.

Administration, Intravesical↗
PubMed1990

Effect of drugs on crystal adhesion to injured urothelium.

The normal urothelium is covered by a glycosaminoglycan (GAG) layer which acts as a barrier to the adhesion of crystals. Destruction of the GAG layer increases the number of adhered crystals, and it is therefore assumed that it promotes crystal growth and stone formation. Intravesical instillation of pentosanpolysulfate, an exogenous glycosaminoglycan, after destruction of this layer reduces the adhesion of crystals to the urothelium. Intramuscular administration of carbenoxolone sodium following the experimental destruction of the GAG layer increases the rate of healing of the layer and reduces the number of adhered crystals.

Adhesiveness↗
PubMed2005

Gemcitabine in intravesical treatment of Ta-T1 transitional cell carcinoma of bladder: Phase I-II study on marker lesions.

OBJECTIVES: To study the ablative activity of intravesical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. METHODS: A total of 27 patients were treated with intravesical gemcitabine after transurethral resection during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six instillations of gemcitabine were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hours, was given at the dose of 500 mg, 1000 mg, and 2000 mg in groups of 9 patients each. A complete response (CR) was defined as negative cytology, cystoscopy, and biopsy findings. Patients achieving a CR received monthly maintenance for up to 1 year and underwent cytology and cystoscopy at 3-month intervals. RESULTS: Of the 27 patients, 1 was lost to follow-up, and of the remaining 26 patients, 6 (23%) achieved a CR. A CR was achieved in 1 patient (12.5%), 2 patients (22.2%), and 3 patients (33.3%) at a dose of 500, 1000, and 2000 mg, respectively. A partial response was obtained in 2 additional patients (22%) at a dose of 500 and 1000 mg. Bladder Tis was diagnosed in 2 patients with a CR at 3 and 8 months after treatment. The remaining 4 patients were disease free at a follow-up of up to 22 months. Systemic and local tolerability was excellent, and no treatment interruption was required. CONCLUSIONS: Our experience has shown the good tolerability and potential efficacy of intravesical gemcitabine against recurrent transitional cell carcinoma of the bladder. Gemcitabine might be proposed, if our results are confirmed by larger studies, as a second-line therapy in patients who cannot tolerate more aggressive intravesical therapy.

Administration, Intravesical↗
PubMed1990

Fatal disseminated mycobacterial infection following intravesical bacillus Calmette-Guerin.

We describe a fatal case of disseminated mycobacteriosis after intravesical bacillus Calmette-Guerin immunotherapy. We summarize the prior safety record of this therapeutic modality, discuss local and systemic pathophysiological mechanisms by which dissemination might have occurred, and review the reported clinical experience with antituberculous chemotherapy for significant bacillus Calmette-Guerin infection. Finally, we offer suggestions for prophylaxis of certain patients with a history of exposure to intravesical bacillus Calmette-Guerin.

Administration, Intravesical↗
PubMed1997

Recurrence of primary superficial bladder cancer treated with prophylactic intravesical Tokyo 172 bacillus Calmette-Guérin: a long-term follow-up.

BACKGROUND: Long-term results after transurethral resection (TUR) and prophylactic intravesical Tokyo 172 bacillus Calmette-Guérin (BCG) therapy for primary superficial bladder cancer were analyzed by multivariate analysis, and factors affecting the recurrence of bladder tumors after this therapy were examined. METHODS: One-hundred and forty-one consecutive patients with primary superficial bladder cancer who consulted the Department of Urology at Wakayama Medical College and affiliated hospitals between May 1985 and May 1990 were studied. Tokyo strain BCG was given intravesically (80 mg in 40 ml saline) weekly for 6 weeks. RESULTS: The 5-year cumulative recurrence-free rate by the Kaplan-Meier method was 0.702 in 141 patients with primary superficial bladder cancer. The 5-year recurrence-free function using the proportional hazard model was 0.743. Using the Cox proportional hazard model, variables that significantly contributed to recurrence after intravesical BCG included female sex, tumor size less than 1 cm in diameter, and T1 tumor stage. Patient age, tumor type, multiplicity, tumor grade, and concomitant carcinoma in situ did not contribute to recurrence. CONCLUSION: Long-term results showed that prophylactic intravesical Tokyo strain BCG after TUR for primary superficial bladder cancer is also effective in preventing the recurrence of bladder cancer, and the biologic behavior of superficial bladder cancer other than stage T1 tumor may be altered after intravesical BCG.

Adjuvants, Immunologic↗
PubMed1995

The persistence of bacille Calmette-Guérin in the bladder after intravesical treatment for bladder cancer.

OBJECTIVE: To determine the incidence of bacille Calmette-Guérin (BCG) bacilli persisting in the urinary tract of patients treated previously with intravesical BCG for carcinoma in situ or multiple Ta.T1 transitional cell carcinoma. PATIENTS AND METHODS: One-hundred and twenty-five patients were treated at the Freeman Hospital, Newcastle upon Tyne, UK over an 8-year period, 90 of whom submitted early morning urine samples for culture for acid-fast bacilli at varying intervals following BCG treatment. The records of all patients were reviewed to determine the incidence of caseating granulomata containing acid-fast bacilli together with the incidence of toxicity and the outcome of treatment. RESULTS: Five patients were found to have persisting acid-fast mycobacteria in their urine or bladder up to 16.5 months after completing intravesical instillations of BCG. In one patient this probably accounted for bladder symptoms that required palliative cystectomy. In four patients the 'infection' was not severe. Two patients were treated with antituberculous chemotherapy without complication. Three years after intravesical BCG therapy 36 of 69 patients (52%) had remained tumour free. CONCLUSION: BCG organisms can persist in the urinary tract for at least 16.5 months after the completion of intravesical BCG instillation therapy.

Administration, Intravesical↗
PubMed1994

[A study of the mechanism of action of BCG against transitional cell carcinoma of the bladder--the change of TNF-alpha and IL-2 in the serum and urine].

To study the mechanism of action of BCG against transitional cell carcinoma of the bladder from the immunological standpoint, we observed time-course changes in the serum and urine levels of tumor necrosis factor (TNF-alpha) and interleukin-2 (IL-2) before and after an intravesical BCG instillation in 16 patients with superficialis transitional cell carcinoma. Serum TNF-alpha concentrations were roughly constant and lower than normal though there was a slight difference between the values before and after BCG instillation or between the test and control values. TNF alpha secretion in urine was increased irrespective of the time for sampling specimens as compared with the control values sampling, remained unaffected by BCG instillations and was increased in many patients even before BCG instillation, probably due to presence of vesical inflammation. No significant changes were detected regarding serum or urine IL-2 before and after BCG instillation and between the test and control values. Thus, the present study failed to demonstrate the involvement of a direct action of TNF-alpha, activation of immunological cells by IL-2 or its direct action as an anti-tumor effect of intravesical instillation of BCG.

Administration, Intravesical↗
PubMedDate not supplied

Tuberculous epididymo-orchitis following intravesical BCG for superficial bladder cancer.

A seventy-two-year-old man with transitional cell carcinoma of the bladder received intravesical Bacillus Calmette-Guérin (BCG) following which he developed left testicular pain and swelling that partially resolved with conservative treatment. Six months later a second course of BCG was given for recurrent disease. Ten months later, he developed left testicular swelling and severe induration along with a draining scrotal sinus. Tuberculous orchitis was suspected and a left orchiectomy was performed. Pathology showed caseating granulomatous orchitis and epididymitis with numerous acid fast bacilli on Ziehl-Neelson stain. The patient received a six-month course of antituberculous therapy. This case highlights a rare but serious complication of intravesical BCG.

Administration, Intravesical↗
PubMed1995

Apparent failure of current intravesical chemotherapy prophylaxis to influence the long-term course of superficial transitional cell carcinoma of the bladder.

During the 4 decades since the first introduction of intravesical chemotherapy, 3,899 patients were enrolled in 22 randomized prospective controlled studies. Of these 22 studies 13 reported a statistically significant benefit of intravesical chemotherapy. With varying followup, the reported decrease in the incidence of patients with tumor recurrence averaged only 14% (range -3 to +43%). Unfortunately, long-term (5-year) studies show no decrease in the incidence of recurrent tumor. Maintenance chemotherapy has failed to improve these results and data suggest that a single early postoperative instillation may, in fact, be most effective. Among 10 studies that include progression data none showed decreased tumor progression, and overall among 2,011 randomized patients progression occurred in 7.5% of those receiving intravesical chemotherapy and 6.9% of those treated by surgery alone. Since intravesical chemotherapy has been demonstrated in animal models to be carcinogenic, these data raise the concern that intravesical chemotherapy might possibly be carcinogenic in humans. In the absence of demonstrated long-term benefit we question the advisability of routine prophylactic intravesical chemotherapy.

Administration, Intravesical↗