The Use of Chemotherapeutic Agents in the Prophylaxis of Papillary Bladder Tumours

Abstract

Prevention of recurrences of papillary bladder tumours was attempted in 93 patients through various measures: addition of Trenimon to the irrigating fluid during and/or after TUR; intravesical instillation of thiotepa, 5-FU, daunomycin or SP-I, administration of various drugs intravenously (mitomycin C, 5-FU) or orally (cyclo-phosphamide, Trenimon, hydroxyurea, methotrexate, procarbazine, SP-G, ascorbic acid). Intravesical instillation yielded the best results, thiotepa appearing to be the drug of choice. Recurrent tumours appeared only after the instillations had been discontinued. A more prolonged treatment is therefore advocated. The addition of drugs to the irrigation fluid has also proved of some value. Among oral drugs, hydroxyurea, procarbazine and methotrexate, displaying a high urinary excretion, appear very promising although the experience is still limited. The association of topical thiotepa with i. v. mitomycin C and 5-FU was employed in 6 cases with muscular invasion, with 2 recurrences and only transient toxic effects. No untoward effects were observed using the other preventive methods.