Effect of Prophylactic Treatment with Intravesical Epirubicin on Recurrence of Superficial Bladder Cancer—The 6th Trial of the Japanese Urological Cancer Research Group (JUCRG):

The Schedule and Duration of Intravesical Chemotherapy in Patients with Non–Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials

“…A further study comparing 4 mo (40 mg/40 ml) to 7 mo (30 mg/40 ml) to 12 mo (20 mg/40 ml) of epirubicin found a higher percentage of patients with recurrence on the 12-mo arm, but treatment duration is confounded with drug concentration so no conclusions can be drawn from this study concerning the optimal duration of treatment [23].…”

“…Comparing 20 mg/40 ml of epirubicin (17 instillations in 12 mo) to 30 mg/40 ml (12 instillations in 7 mo) to 40 mg/40 ml (9 instillations in 4 mo), the percentage of patients with recurrence decreased as the drug concentration increased despite the decrease in the duration of treatment [23].…”

2‐micrometer continuous wave laser treatment for multiple non‐muscle‐invasive bladder cancer with intravesical instillation of epirubicin

“…Oncogenesis was a diffuse ongoing process in the urothelium of these patients, and we believe that laser treatment cannot change the overall formation of new tumors. Although the establishment of the optimal treatment regimen for epirubicin is hampered by differences in dose, concentration, instillation schedule, frequency of instillation [12], the small size of some trials, post-operative instillation with epirubicin decreasesthe number of relapses after Ta/T1 bladder tumor resection [13]. Kuroda et al [12] randomized 622 patients with Ta-T1 G1-2 NMIBC for adjuvant treatment with 17doses of epirubicin 20 mg/40 ml in12 month, 12 doses of epirubicin 30 mg/40 ml in 7 month, or 9 doses epirubicin 40 mg/40 ml in 4 months.…”

“…Although the establishment of the optimal treatment regimen for epirubicin is hampered by differences in dose, concentration, instillation schedule, frequency of instillation [12], the small size of some trials, post-operative instillation with epirubicin decreasesthe number of relapses after Ta/T1 bladder tumor resection [13]. Kuroda et al [12] randomized 622 patients with Ta-T1 G1-2 NMIBC for adjuvant treatment with 17doses of epirubicin 20 mg/40 ml in12 month, 12 doses of epirubicin 30 mg/40 ml in 7 month, or 9 doses epirubicin 40 mg/40 ml in 4 months. At 2-year followup, the recurrence-free rates were 48.7%, 55.1%, and 60.1%, respectively, showing the greatest effect by the highest dose regimen, administered over a short period of time.…”

Guía clínica del carcinoma urotelial no músculo invasivo de la Asociación Europea de Urología

“…Se ha demostrado que ajustando el pH urinario, disminuyendo la excreción urinaria, y amortiguando la solución intravesical se reducen las tasas de recidiva 31 (nivel de evidencia: 1b).…”