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At least 55 records · Page 3Linked to original sources
PubMed1986

Intravesical chemotherapy. Studies on the relationship between pH and cytotoxicity.

The influence of pH on the antitumor activity of drugs used for intravesical chemotherapy was studied. A human continuous cell line derived from a transitional cell carcinoma of the bladder was exposed to 6 drugs (Adriamycin [doxorubicin], cisplatin, epirubicin, epodyl, mitomycin C, and thiotepa) for 1 hour at 11 pH values ranging from 5.2 to 9.7, and cytotoxicity was measured by inhibition of colony formation. pH had a marked influence on drug activity: cisplatin, mitomycin C, and thiotepa were most cytotoxic in acid media, Adriamycin, and epirubicin in alkaline media, while epodyl was the only drug whose cytotoxicity was unaffected by pH. In addition to these in vitro studies, comparisons were made of the pH of urine samples obtained from patients immediately before and at the completion of intravesical chemotherapy. Changes in pH up to a maximum of +/- 1.6 units were observed, although in most cases, values were similar before and after therapy. All the drugs used were acidic in solution, with the exception of thiotepa. It is concluded that by adjusting solvent and urine pH to the optimum value for each drug, the effectiveness of intravesical chemotherapy might be enhanced.

Antineoplastic Agents↗
PubMed1990

Secondary hematologic neoplasm after intravesical chemotherapy for superficial bladder carcinoma.

Two cases are reported of patients who developed a hematologic malignancy several years after intravesical chemotherapy of superficial bladder cancer with etoglucid, doxorubicin, and mitomycin C. In one patient, karyotypic abnormalities (-5, 7q-) typical of a therapy induced malignancy were associated with rapid progression of a refractory anemia with excess blasts in transformation to an acute non-lymphocytic leukemia. Intravesical chemotherapy may be associated with a risk of secondary malignancy.

Aged↗
PubMed1986

Intravesical chemotherapy: in vitro studies on the relationship between dose and cytotoxicity.

The relative importance of two variables, drug concentration and period of exposure, in relation to the therapeutic potential of intravesical chemotherapy was examined in an experimental system. A human bladder cancer cell line was exposed to a range of concentrations of the four drugs commonly used to treat superficial bladder cancer (adriamycin, epodyl, mitomycin-c, thiotepa) for periods of 30, 60 and 120 min. An exponential relationship was observed between clonogenic cell kill and both drug concentration and period of exposure. Thus, under the experimental conditions employed, cytotoxicity is proportional to dose (i.e. concentration X period of exposure). These two variables are of equal importance in relation to tumor cell kill, indicating that maximum therapeutic benefit may be obtained by using the highest concentration achievable for as long as the patient can retain the instillate, bearing in mind the potential increase in toxicity to the patient and the cost.

Antineoplastic Agents↗
PubMed1987

Intravesical chemotherapy: combination with Tween 80 increases cytotoxicity in vitro.

Tween 80 was shown to enhance significantly the cytotoxic activities of the four drugs (adriamycin, epodyl, mitomycin-c, thiotepa) most frequently administered intravesically to treat superficial bladder cancer. The colony forming ability of a human bladder cancer cell line, RT112, was measured following a 1 h exposure to each of the four drugs both alone and in combination with 0.1% and 0.3% Tween 80. Cell survival was not reduced by 0.1% Tween 80 alone. We conclude that the combination of Tween 80 with these drugs might increase the therapeutic index of intravesical chemotherapy.

Administration, Intravesical↗
PubMed1978

The acute effects of various cytotoxic compounds injected into the prostate glands of dogs.

The acute effects of direct injections with various cytotoxic compounds into the prostates of adult dogs were studied microscopically. The effects remained localised to the site of injection, with no diffusion of the agents into other areas of the prostate. No systemic effects were observed despite the high concentrations used. The main histological changes consisted of local aseptic necrosis at the injection site surrounded by atrophy of the acinar epithelium.

Animals↗
PubMed1992

Intravesical therapy with adriamycin and 4-epirubicin for superficial bladder cancer: the experience of the EORTC GU Group.

The anthracycline derivatives Adriamycin and 4-epirubicin are used to prevent recurrent tumors after transurethral resection of superficial bladder tumors. Both drugs are instilled intravesically. The present report describes the results of two multicenter, prospective, randomized phase III studies carried out by the EORTC GU Group. In protocol 30,790, after a mean follow-up period of 26.6 months, the recurrence rate for 165 patients treated with Adriamycin was 0.29 and the tumor rate was 0.74. For 156 patients treated with Epodyl, the recurrence rate was 0.29 and the tumor rate was 0.57. This difference was not statistically significant. For 70 patients who received transurethral resection alone, the recurrence rate was 0.65 and the tumor rate, 2.04. In protocol 30,763, patients with good prognostic factors were treated with one single instillation of 4-epirubicin versus sterile water. After a mean follow-up period of 16 months, in 190 patients treated with 4-epirubicin the recurrence rate was 0.20 and the tumor rate was 0.35; in 196 patients treated with sterile water, the recurrence rate was 0.37 and the tumor rate was 0.65 (P = 0.0001). Adriamycin and 4-epirubicin were efficacious, and severe side effects were not encountered. The superiority of Adriamycin over Epodyl could not be proven.

Administration, Intravesical↗
PubMed1978

Epodyl in management of noninvasive vesical neoplasms.

A prospective study to assess the effects of triethylene glycol diglyceridyl ether (Epodyl) in the management of superficial noninvasive vesical neoplasm (T1) is presented. Apart from a few local side effects, the response of the tumor to Epodyl was very good as assessed up to three years. Further long-term studies are being done.

Diathermy↗
PubMed1986

Intravesical chemotherapy: studies on the relationship between osmolality and cytotoxicity.

The effectiveness of intravesical chemotherapy for the treatment of superficial bladder cancer may be influenced by the conditions of administration, such as the osmotic strength of the instillate. Urine from patients with bladder cancer before treatment had osmolalities in the range 187 to 852 mOsm./kg. and these had decreased by an average of 135 mOsm./kg. at the completion of intravesical chemotherapy. Clinical preparations of drugs used for intravesical chemotherapy had osmotic strengths ranging from 65 to 1,038 mOsm./kg. The antitumor activities of the drugs most frequently used intravesically (doxorubicin, epodyl, mitomycin C and thiotepa), and of cisplatin and epirubicin in media of 6 different osmolalities were measured with a human bladder cancer cell line by inhibition of colony-forming ability. Reducing osmotic strength from 590 to 125 mOsm./kg. significantly increased the in vitro cytotoxicities of thiotepa, mitomycin C, cisplatin and epirubicin but not those of doxorubicin and epodyl. We conclude that the use of an instillate at the lowest achievable osmotic strength probably will be optimal for the intravesical administration of chemotherapeutic drugs.

Antineoplastic Agents↗
PubMed1982

Prognostic factors influencing survival of patients receiving intravesical epodyl.

Results from a retrospective analysis of 139 patients with recurrent superficial bladder tumors treated by intravesical epodyl are reviewed. Of patients who had complete clearance of tumor from the bladder 95 per cent became free of disease within 12 months of starting intravesical therapy. No patient who had persistent tumors at 2 years was free of tumor subsequently. The majority of complete responders who suffered recurrences did so within 3 years and 80 per cent of a small series of patients who remained free of tumor after 3 years and then stopped treatment continued to be free of tumor for a further 2 years. Failure to respond within 12 months or early invasion of the submucosa on biopsy (stage P1b tumors) was associated with poor survival. In patients who underwent salvage cystectomy the demonstration that 35 per cent had involved metastatic lymph nodes and 38 per cent had invasion of muscle is a clear indication of the dangers of delaying radical treatment once the patient has failed to respond completely to intravesical therapy.

Antineoplastic Agents↗
PubMed1977

Intravesical epodyl in the management of bladder tumors: combined experience of the Yorkshire Urological Cancer Research Group.

Of 48 patients with bladder tumors treated with intravesical epodyl 17 have shown a complete remission at some stage of treatment, although several have relapsed later. Partial remission occurred in 20 patients and 11 have shown no improvement or the lesions have progressed. Epodyl is used best as an adjunct to transurethral resection or diathermy of T1 bladder lesions. Even in patients who do not show complete remission epodyl may reduce the incidence of recurrence and the number of lesions. It is useful when rapid recurrence of T1 bladder tumors prevents control by resection or diathermy and it also is beneficial as an emergency measure to control hematuria. Complications are not infrequent and may be severe occasionally. Bone marrow depression has been seen in 2 patients whose bladders showed extensive carcinoma in situ.

Adult↗
PubMed2000

An overview of the treatment of superficial bladder cancer. Intravesical chemotherapy.

Superficial bladder cancer accounts for approximately 70% to 80% of all newly diagnosed bladder cancers. The vast majority of these cancers are transitional bladder tumors of various histologic grades (I to III). Superficial tumors include carcinoma in situ (CIS), tumors confined to the epithelium (Ta), and superficial tumors that invade the lamina propria (T1) but do not involve superficial muscle layers. The primary treatment for eradication of stage Ta and T1 bladder cancers is transurethral resection of the tumor. Many patients with superficial bladder tumors treated with endoscopic surgery alone have recurrence or tumor progression at some point in their follow-up, and, in these patients, the need for adjuvant treatment becomes a major concern.

Administration, Intravesical↗