Takeuchi S

Intravesical Combination Chemotherapy with Mitomycin C and Doxorubicin for Carcinoma in Situ of the Bladder

We treated 30 patients with carcinoma in situ of the bladder via intravesical combination chemotherapy. As an induction therapy 20 mg. mitomycin C on day 1 and 40 mg. doxorubicin on day 2 were instilled into the bladder once a week for 5 consecutive weeks. Patients who achieved complete response were assigned a maintenance instillation of mitomycin C alone every 2 to 4 weeks for 1 year. A total of 19 patients achieved complete response following an initial course of induction therapy and 2 partial responders to initial therapy also achieved complete response after repeated induction therapy, resulting in a 70 per cent over-all complete response rate. Toxicity was considerable with moderate to severe bladder irritation occurring in 20 patients but it was tolerable in the majority. Of 21 complete responses 13 remained free of disease for 6 to 43 months (average of 23 months), 5 had recurrent carcinoma in situ and 1 had invasive urethral cancer. In contrast, of 9 nonresponders 2 and 1 had invasive cancer of the bladder and ureter, respectively.

Pretreatment with chlormadinone acetate eliminates testosterone surge induced by a Luteinizing-hormone-releasing hormone analogue and the risk of disease flare in patients with metastatic carcinoma of the prostate

We investigated the efficacy of 2-week and 4-week pretreatments with 100 mg/day chlormadinone acetate (CMA) to prevent the flare reaction induced by luteinizing-hormone-releasing hormone (LHRH) in patients with metastatic carcinoma of the prostate. CMA lead-in therapy suppressed bone pain and serum levels of luteinizing hormone, testosterone and prostate-specific antigen levels. CMA therapy also suppressed the transient increases in these levels associated with the initiation of therapy. The 4-week regimen appeared to be more effective than the 2-week regimen.