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PubMed1995

A randomized study of intravesical mitomycin C, bacillus Calmette-Guerin Tice and bacillus Calmette-Guerin RIVM treatment in pTa-pT1 papillary carcinoma and carcinoma in situ of the bladder.

Results of a randomized prospective study are reported in which mitomycin C, Tice bacillus Calmette-Guerin (BCG) and RIVM-BCG were compared in 437 patients with primary or recurrent pTa and pT1 bladder tumors, including carcinoma in situ. The followup (or time in study) varied from 2 to 81 months (mean 36 months). After complete transurethral resection of all visible tumors the patients were treated with 30 mg. mitomycin C once a week for 4 consecutive weeks and thereafter every month for a total of 6 months, and 5 x 10(8) colony-forming units Tice BCG or RIVM-BCG once a week for 6 consecutive weeks. For papillary tumors mitomycin C and RIVM-BCG treatments were equally effective (p = 0.53), and mitomycin C was more effective than Tice BCG therapy (p = 0.01).

Administration, Intravesical↗
PubMedDate not supplied

[Effect of nalidixic acid and mitomycin C on growth and biosynthesis of extracellular proteins by Serratia marcescens].

The effect of various concentrations of nalidixic acid and mitomycin C on the dynamics of growth of Serratia marcescens and synthesis of endonuclease and other extracellular enzymes by it was studied. The synthesis of extracellular endonuclease was induced during inhibition of the cell division under the effect of nalidixic acid and mitomycin C. The induction of the endonuclease synthesis preceded the start of the division of the resistant cells which overcame the phase of the population retarded growth. The fermentation broth of the cells exposed to nalidixic acid and mitomycin C contained increased amounts of protein and possessed higher activities of chitin phosphodiesterase and phosphatase. It was shown by PAAG-electrophoresis with sodium dodecyl sulphate that the pattern of the extracellular proteins of S. marcescens undergone quantitative and qualitative changes under the effect of nalidixic acid and mitomycin C.

Bacterial Proteins↗
PubMed1996

Marker tumour responses to the sequential combination of intravesical therapy with mitomycin-C and BCG-RIVM in multiple superficial bladder tumours. Report from the European Organisation for Research and Treatment on Cancer-Genitourinary Group (EORTC 30897).

OBJECTIVES: To study the ablative activity of intravesical mitomycin C followed by intravesical bacillus Calmette-Guérin (BCG) on a papillary marker tumour and to determine the incidence of side effects. METHODS: Thirty-five patients with multiple pTa or pT1 bladder tumours were treated with 4 instillations of mitomycin C at weekly intervals followed by 6 instillations at weekly intervals of BCG-RIVM. All visible tumours were resected before starting intravesical instillations except one marker tumour. Response was determined 2 weeks after the last instillation. RESULTS: The incidence of adverse effects was similar to previously reported toxicity of either mitomycin C or BCG alone. Complete response, histologically proven, was observed in 16 of 35 patients and in 3 patients without histological confirmation. One patient showed progression. CONCLUSION: The sequential combination of mitomycin C and BCG is an efficacious treatment. The measurement of response to a marker tumour is a safe and efficient method to test new drugs or combinations of drugs.

Adjuvants, Immunologic↗
PubMed1996

Alternating mitomycin C and bacillus Calmette-Guerin instillation prophylaxis for recurrent papillary (stages Ta to T1) superficial bladder cancer. Finnbladder Group.

PURPOSE: We attempted to prove if alternating chemoprophylactic and immunoprophylactic instillations improved efficacy and decreased toxicity in patients with recurrent superficial bladder cancer. MATERIALS AND METHODS: A total of 188 patients with rapidly recurring stage Ta or T1 cancer was randomly treated with mitomycin C (group 1) or alternating mitomycin C and Pasteur strain bacillus Calmette-Guerin (BCG) instillations (group 2) for 2 years. Mean followup was 34 months. RESULTS: Median times to initial recurrence were 12 months in group 1 and 7 months in group 2 (p = 0.976), and treatment failed in 21.5% and 18.9%, respectively. Recurrence rates during the instillation period were 1.01 in group 1 and 0.86 in group 2 (p = 0.376). There was no difference in the disease-free interval between the 2 groups (p = 0.976). Instillations were discontinued because of adverse effects in 6 cases (6%) in both groups. CONCLUSIONS: Efficacy of alternating mitomycin C and BCG was equal to mitomycin C monotherapy, and both methods were effective in prophylaxis of recurrent papillary bladder cancer. Less toxicity occurred in the alternating treatment group compared to earlier BCG monotherapy results.

Adjuvants, Immunologic↗
PubMed1996

Histology of conjunctival vascular endothelium after filtering surgery with mitomycin C in rabbits.

OBJECTIVE: To examine histologic changes in conjunctival vasculature during the first 72 hours following filtering surgery with adjunctive mitomycin C in rabbits. DESIGN: Thirty-six New Zealand white rabbits underwent unilateral posterior lip sclerectomy. In 18 rabbits mitomycin C (0.5 mg/mL) was applied subconjunctivally for 5 minutes. The remaining 18 animals were treated with the phosphate-buffered saline vehicle for 5 minutes. Three rabbits from either group were killed at 0, 4, 12, 24, 48 and 72 hours postoperatively. OUTCOME MEASURES: Degree of vascularity of filtering blebs on gross examination and appearance of conjunctival vascular specimens on light and transmission electron microscopy, as assessed by three masked observers. RESULTS: On gross examination the filtering blebs in the mitomycin C group were slightly less hyperemic than those in the control group at 12, 24 and 48 hours and were markedly less hyperemic at 72 hours. Light microscopy showed tightly packed erythrocytes within the conjunctival vessels of the experimental blebs and an almost total absence of endothelium within many of the vascular channels by 72 hours. Transmission electron microscopy showed focal loss of vascular endothelial cells and thrombus formation in the experimental blebs, as early as 12 hours postoperatively. CONCLUSIONS: Our findings suggest that the decreased vascularity of filtering blebs observed after trabeculectomy with adjunctive mitomycin C is at least partially due to a toxic effect of the agent on the endothelial cells of the conjunctival vessels.

Animals↗
PubMed1996

[Prevention of superficial bladder cancer with mitomycin C or interferon: final results of a prospective study].

OBJECTIVES: Herein we present the final results of a prospective randomized study comparing two prophylactic treatment modalities for superficial bladder tumors: chemotherapy with mitomycin C and immunotherapy with interferon. METHODS: The study comprised 65 patients. Mitomycin C was utilized in 34 and interferon in 31 patients. RESULTS: The mitomycin C-treated patients had 41% recurrence, 1.7 recurrence/100 patients-month, 17 months mean time to recurrence and 8.8% tumor progression. The patients receiving interferon had 45% recurrence, 2.4 recurrence/100 patients-month, 12 months mean time to recurrence and 22.2% tumor progression rate. No significant differences were observed between the two groups of patients. Treatment was well-tolerated by both groups and the cost:efficacy ratio was higher for the interferon-treated patients. CONCLUSIONS: Immunoprophylaxis with interferon is as effective, but costs more than chemoprophylaxis with mitomycin C. Both agents have a moderate effect relative to control of recurrence, time to recurrence and tumor progression.

Adult↗
PubMed1996

Surgical results and complications of trabeculectomy with intraoperative application of mitomycin C.

Trabeculectomy is reportedly less effective in aphakic eyes, secondary glaucoma, juvenile patients, and eyes with a history of unsuccessful glaucoma surgery. We evaluated the surgical effects and complications of trabeculectomy with the adjunctive use of mitomycin C, an antiproliferative drug, in a number of refractory cases. Forty patients (50 eyes) with refractory glaucoma were treated with trabeculectomy and the adjunctive use of mitomycin C and were followed postoperatively for at least 3 months. The mean follow-up period was 13.6 +/- 7.5 months (range: 3 to 31 months). In 43 eyes (86%), intraocular pressure was well controlled at < or = 21 mmHg. Complications included corneal epithelial damage (30 eyes), shallow anterior chamber (20 eyes), hyphema (19 eyes), choroidal detachment (18 eyes), leakage of aqueous humor from the conjunctival wound (4 eyes), and endophthalmitis (1 eye). The results of trabeculectomy with intraoperative use of mitomycin C in this series of procedures demonstrates that this can be a useful and effective treatment; however, mitomycin C may cause transient decreased visual acuity due to inhibited wound healing and the resultant overfiltration.

Adolescent↗
PubMed1997

Combined phacoemulsification and trabeculectomy with mitomycin-C.

BACKGROUND AND OBJECTIVE: To evaluate the effectiveness of combined phacoemulsification and trabeculectomy with mitomycin-C with respect to visual rehabilitation and control of intraocular pressure in patients with coexisting cataract and glaucoma. PATIENTS AND METHODS: The authors retrospectively studied 20 consecutive cases of phacoemulsification with posterior chamber intraocular lens implantation combined with trabeculectomy using mitomycin-C. They included in their study 20 eyes of 19 patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, inflammatory glaucoma, chronic angle-closure glaucoma, and normal tension glaucoma. RESULTS: After a mean postoperative follow-up time of 14.4 +/- 3.1 months, intraocular pressure was reduced from a preoperative mean of 19.2 +/- 6.1 mm Hg to a postoperative mean of 13.4 +/- 3.9 mm Hg (P = .0004). The number of required intraocular pressure-lowering medications dropped from a preoperative mean of 2.3 +/- 0.7 medications to 0.2 +/- 0.4 medications postoperatively (P < .0001), with only 4 eyes requiring the restarting of a single medication each. Mean log10 (minimum angle of resolution) visual acuity improved from a preoperative 0.66 +/- 0.53 (Snellen 20/91) to a postoperative 0.30 +/- 0.40 (Snellen 20/40) (P < .0005). The most frequent complication was a bleb leak (8 of 20 eyes [40%]), usually occurring early and responding to conservative management. One eye with later-onset bleb leak incurred endophthalmitis. In another eye, hypotony with maculopathy developed. CONCLUSIONS: Phacoemulsification combined with trabeculectomy using mitomycin-C appears to be an effective approach to the management of cataract in patients with glaucoma. It offers potential for good improvement in visual acuity as well as long-term control of intraocular pressure with reduced or no dependence on medications. Potential vision-threatening complications of this procedure, specifically hypotony maculopathy and late-onset bleb leaks, should be considered in the decision to use mitomycin-C.

Aged↗
PubMed1997

Trabeculectomy with mitomycin-C for postkeratoplasty glaucoma: a preliminary study.

BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of trabeculectomy with mitomycin-C in the management of postkeratoplasty glaucoma. PATIENTS AND METHODS: Included in this study were 16 eyes of 16 patients who underwent trabeculectomy with mitomycin-C for medically uncontrolled postkeratoplasty glaucoma, each having at least 6 months of follow-up. RESULTS: The mean pretrabeculectomy intraocular pressure (IOP) with maximal medical therapy was 34.6 mm Hg (range 24-45 mm Hg). The mean IOP following trabeculectomy with mitomycin-C was 14.2 mm Hg (range 8-36 mm Hg) by the end of a mean follow-up of 14.2 months (range 8-32 months). Fourteen eyes (87.5%) had complete success, 1 eye (6.25%) had qualified success, and 1 eye (6.25%) had failure. All the patents had the same or better visual acuity, compared with the preoperative value. None of the patients had postoperative complications, such as shallow anterior chamber, epithelial defect, or hypotony. CONCLUSIONS: Trabeculectomy with mitomycin-C is a safe and effective modality in the management of medically uncontrolled postkeratoplasty glaucoma.

Administration, Topical↗
PubMed1998

Ultrastructural changes in rabbit ciliary body after extraocular mitomycin C.

PURPOSE: To study the ultrastructural changes in ciliary body epithelium of the rabbit eye after subconjunctival injections of mitomycin C. METHODS: One eye of six New Zealand white rabbits was given a subconjunctival injection at the 12-o'clock position with 0.005, 0.02, 0.08, 0.1, 0.12, or 0.16 mg mitomycin C. The fellow eye was given a subconjunctival injection of balanced salt solution. Two weeks after treatment, the eyes were enucleated, and the ciliary body was exposed and submerged in fresh 4% paraformaldehyde/2% glutaraldehyde in 0.1 M phosphate buffer, pH 7.4, at 4 degrees C. Electron microscopy of the ciliary body was performed at two sites: the injection site (12-o'clock position) and 180 degrees away (6-o'clock position). RESULTS: At dosages of 0.1 mg and higher, ciliary body epithelial cells beneath the injection site were thinned. There were vacuoles and expansion of intracellular and intercellular spaces. Plasma membrane infoldings were disrupted, and the apical membrane was thinned. Mitochondria and nuclei were normal. Ciliary body epithelium at 6-o'clock position showed only mild architectural distortion of the plasma membrane infoldings. Eyes that received lower doses of mitomycin C (0.005 mg, 0.02 mg, and 0.08 mg) and balanced salt solution showed normal ciliary body epithelium at the injection site and 180 degrees away. CONCLUSIONS: Subconjunctival injection of mitomycin C in the rabbit produces dose-dependent localized ultrastructural changes of the ciliary body epithelium.

Animals↗
PubMed1998

[A comparative study of thio-tepa and mitomycin C in the treatment of pterygium. Preliminary results].

AIMS: To compare the efficacy of Thio-tepa and Mitomycine C to obviate recurrence; to compare cost-efficacy ratios; to evaluate their facility of use and their complications. METHODS: In a prospective blinded study, 36 patients undergoing surgery for 46 primary and recurrent pterygium were assigned randomly to three groups: group 1 received 0.02 mg/ml of Mitomycine C three times daily for 5 days; group 2 received Thio-tepa four times daily for 6 weeks, group 3 served as a control receiving distilled water three times daily for five days. RESULTS: Recurrence rates were 38%, in group 1; 28% in group 2; 82% in group 3 respectively. Follow-up ranged from 15 to 44 weeks (mean 27.93 +/- 8.9 weeks). Mean delay recurrence time was 6.3 weeks. Topical Mitomycin caused: iritis, conjunctival irritation, excessive lacrymation, photophobia, ocular pain; Thio-tepa caused: photophobia, foreign body sensation, headache. CONCLUSIONS: Mitomycine C appears to be an effective and safe adjunctive treatment for this cost-efficacy and this facility of use comparison.

Administration, Topical↗
PubMed1998

Combined phacoemulsification and trabeculectomy versus trabeculectomy alone: a comparison study using mitomycin-C.

BACKGROUND AND OBJECTIVE: To compare the results of combined phacoemulsification and trabeculectomy (PEM/TRAB) plus mitomycin-C with those of trabeculectomy alone (TRAB) plus mitomycin-C. PATIENTS AND METHODS: The authors retrospectively reviewed 42 eyes in 38 consecutive patients who underwent combined PEM/TRAB with mitomycin-C. An age-matched control group of 42 patients who underwent TRAB with mitomycin-C during the same time period was randomly selected from 248 consecutive patients. All patients had a minimum of 12 months of follow-up. RESULTS: Mean preoperative intraocular pressure (IOP) and number of glaucoma medications were similar for the two groups (22.8 +/- 6.9 mm Hg vs 22.9 +/- 6.8 mm Hg, 2.12 +/- 0.8 vs 2.26 +/- 1.0 medications, combined PEM/TRAB vs TRAB, respectively). Postoperative IOP was significantly lower at all follow-up intervals. At final follow-up after a mean of 21.8 +/- 6.0 months, IOP averaged 13.9 +/- 5.1 mm Hg in the PEM/TRAB group and 12.3 +/- 4.7 mm Hg in the TRAB group. Bleb survival was excellent in both groups, although slightly higher in the TRAB group (37 of 42 PEM/TRAB vs 41 of 42 TRAB). Both groups required significantly fewer glaucoma medications at final follow-up (0.38 +/- 0.6 vs 0.5 +/- 0.8, PEM/TRAB vs TRAB). Complications were similar between the two groups. CONCLUSION: The success rate for combined PEM/TRAB appears to approach that of TRAB alone.

Aged↗
PubMed1997

[The clinical effect after locally using mitomycin C during trabeculectomy in glaucoma].

To improve the function of filtering blebs after trabeculectomy, we divided randomly 44 patients (60 eyes) with moderate or late glaucoma into mitomycin C and control groups (30 eyes per group). Two small surgical sponges were soaked with 0.2 mg.ml-1 mitomycin C solution. One sponge was put on the top of the superficial scleral flap, the other was placed underneath the scleral flap and contacted with the bed of the scleral flap. After 5 minutes the wound was then irrigated with normal saline. All patients were followed up from 1 to 12 months (7.9 +/- 4.0 months). We found that: (1) functional filtering blebs were 92.9% in the mitomycin C group and 55.2% in the control group (P < 0.01), (2) the decreasing percentage of intraocular pressure (IOP) in the mitomycin C group was much more than that in the control group (P < 0.05), (3) the successful rates of the operation in MMC group were higher than that of the control group, and the visual field was effectively maintained in MMC group.

Administration, Topical↗
PubMed1963

MITOMYCIN C: CHEMICAL AND BIOLOGICAL STUDIES ON ALKYLATION.

The presence of an aziridine ring in mitomycin C suggests that the mechanism of action of the antibiotic is like that of the antitumor alkylating agents. However the compound is unexpectedly stable during aerobic incubation with rat liver homogenates although rapidly metabolized anaerobically. Mitomycin is not reactive with gamma-(4-nitrobenzyl) pyridine and reacts only slowly at acid p(H) with thiosulfate. It is proposed that mitomycin is activated in vivo, possibly by a reduction which "unmasks" the potential activity of the fused aziridine ring.

Alkylation↗
PubMed1964

MITOMYCINS AND PORFIROMYCIN: CHEMICAL MECHANISM OF ACTIVATION AND CROSS-LINKING OF DNA.

Mitomycins and porfiromycin, generally nonreactive in the natural oxidized state, behave as bifunctional "alkylating" agents upon chemical or enzymatic reduction, followed by spontaneous loss of the tertiary methoxy (hydroxyl) group and formation of an aromatic indole system. Thus activated, mitomycins and porfiromycin react in vitro with purified DNA, linking its complementary strands. A high content of guanine and cytosine favors this cross-linking reaction, which is the basis of the lethal effect in vivo of these antibiotics. The activation and cross-linking reactions are discussed in terms of reactive sites on the mitomycin and DNA molecules.

Anti-Bacterial Agents↗
PubMed1991

Modulation of corneal wound healing after excimer laser keratomileusis using topical mitomycin C and steroids.

A 193-nm excimer laser system was used to create deep stromal ablations in seven New Zealand white rabbits and shallow ablations in three. Eyes were randomized for treatment with topical mitomycin C, steroids, and erythromycin; topical steroids and erythromycin; or topical erythromycin only. All treatment regimens were instituted twice daily for 14 days. All eyes reepithelialized normally within 3 to 5 days. During 10 weeks of follow-up, all eyes developed moderate reticular subepithelial haze without significant differences among treatment groups. Results of light, fluorescence, and electron microscopic examination showed anterior stromal scarring and markedly reduced new subepithelial collagen formation in the group treated with mitomycin C, corticosteroids, and erythromycin. Focal abnormalities of Descemet's membrane and endothelial abnormalities were present in all treatment groups. Combination therapy with topical steroids, mitomycin C, and erythromycin to control the corneal wound healing response after refractive laser surgery appears promising and warrants further study.

Administration, Topical↗
PubMed1982

Mitomycin-C, methotrexate, bleomycin and cis-diamminedichloroplatinum II in the chemotherapy of advanced squamous cancer of the head and neck.

Thirty-four patients with advanced squamous cancer of the head and neck were treated with an outpatient regimen combining mitomycin-C, cis-diamminedichloroplatinum (II), methotrexate and bleomycin. Five had complete remissions and 15 partial remissions, for an overall response rate of 59%. Responses were noted on 11 of 13 patients (85%) with disease above the clavicles without prior irradiation. Median duration of partial remission was four months. Response rate was independent of age, performance status, presence of distant metastases and primary site. Hematologic toxicity was substantially more severe with this program than had been observed in a prior study using the same regimen without mitomycin-C. Since neither complete nor partial response rates, nor response durations improved with the addition of mitomycin, we conclude that it adds little to the efficacy of the other three agents.

Adult↗
PubMed1985

Combined thiotepa and mitomycin C instillation therapy for low-grade superficial bladder tumor.

Fifteen patients with superficial low-grade bladder tumors were treated with combined thiotepa and mitomycin C instillation as definitive therapy. The amount of both thiotepa and mitomycin C used in each instillation in the presenting protocol was one half the conventional dose of either used alone. Patients with multiple bladder tumors, bladder tumors inaccessible to endoscopic resection, or lesions too extensive to completely resect, or with medial contraindications for endoscopic resection procedures, were included in these studies. No serious adverse effect was revealed in these 15 patients. Ten of the 15 patients (66.7%) had a complete response and 4 (26.7%) had a partial response. One patient (6.6%) did not respond to this regimen. This protocol seems to provide a therapeutic modality that is more effective than conventional single-drug therapy, less toxic than thiotepa used alone, and less expensive than mitomycin C used alone.

Aged↗