Quimioprofilaxis en la recidiva tumoral vesical / Chemoprophylaxis in the vesical tumoral recurrence

Los tumores vesicales superficiales se caracterizan por una alta tasa de recidiva, que ocurre especialmente dentro de los dos primeros años, y que es aun mayor en los grupos de alto riesgo. Existe consenso en la utilidad del uso del Bacilo de Calmette-Guerin para disminuir la recurrencia tumoral. La quimioterapia intravesical con otros medicamentos han demostrado su utilidad o no en disminuir la recurrencia de estos tumores vesicales. Entre los años 1999 y 2008 se estudian y tratan 110 pacientes (96 hombres y 14 mujeres), con una edad promedio de 63 años, divididos en tres grupos para tratamiento de la recidiva tumoral después de resección transuretral o cistectomía parcial, con tres diferentes agentes quimioprofilácticos e inmunomoduladores (Thio-Tepa, BCG+factor de transferencia, doxorrubicina+interferón alfa 2b). El objetivo de esta investigación fue presentar la experiencia en el tratamiento de estos pacientes, donde se observa mejores resultados en 5 años, con el grupo tratado con doxorrubicina+interferón alfa 2b, seguido del grupo tratado con BCG+factor de transferencia, con una marcada disminución de las recurrencias y una limitación en la progresión de la enfermedad a largo plazo.

The superficial bladder tumors are characterized by a high rate of recurrence taking place especially within the first two years that is even higher in the high risk groups. There is an agreement in the usefulness of the Calmette-Guerin Bacillus (CGB) to diminish the tumoral recurrence. The intravesical chemotherapy with other medications have demonstrated its profit or not in decreasing the recurrence of these bladder tumors. Between 1999 and 2008 we studied and treated 110 patients (96 men and 14 women), aged in average 63 years old. They were divided into three groups for the treatment of the tumoral recidivism after the transurethral resection or partial cystectomy, using three different chemoprophylactic agents and inmunomodulators (Thio-Tepa, BCG+Transference Factor, Doxorubicin +Interferon Alpha 2b). The objective of this research was presenting our experience in the treatment of these patients during five years, obtaining better results in the group treated with doxorubicin + interferon alpha 2b, followed by the group treated by means of BCG + transference factor, with a remarked decrease of the recurrence and a limitation in the long term progression of the disease.

Testicular Cytotoxicity of Intraperitoneal Thio-TEPA in Mice / 대한비뇨기과학회지

Mice were used to evaluate the adverse testicular effects of anticancer agents. Testicular cytotoxicity of many chemotherapeutic drugs has been evaluated in mice. In this report, we described thio-TEPA induced testicular toxicity in mature male I. C. R. mice. On day o, mice in the treatment groups were given different single intraperitoneal doses of thio-TEPA(0.1 to 25mg/kg). On day 56, all surviving mice were killed and necropsied. Testicular toxicity was evaluated qualitatively by histology and quantitatively by testicular weight(testis weight/body weight), repopulation index and epididymal index. Progressive dose dependent testicular atrophy and oligospermia occurred at low and intermediate doses of thio-TEPA(0.1 to 5mg/kg). Marked testicular atrophy, oligospermia and germinal aplasia were observed at high dose of thio-TEPA(10mg/kg). LD50 for animal mortality at day 56 for thio-TEPA appears to be 25mg/kg. In this report, we described the quantitative relationship between thio-TEPA dosage and testicular cytotoxicity in mature male I. C. R. mice.

Prophylactic Intravesical Chemotherapy in Superficial Bladder Tumors / 대한비뇨기과학회지

Superficial bladder tumors are usually treated by TUR. However, recurrence of the tumor after complete resection occurs in about 50-70%, of the patients with a significant percentage of these recurrences showing a higher degree of malignancy. In 10% of the cases, the tumor progresses to invasive carcinoma. Most of these recurrent tumors will occur within 6-12 months. The multifocal nature of these tumors and the frequent recurrences after TUR indicate a need for adjuvant chemotherapy to reduce or delay the incidence of recurrence tumors. We studied to evaluate prophylactic effects of topical chemotherapy in 116 cases with superficial bladder tumors admitted to the Department of Urology, Keimyung University School of Medicine during the period from Jenuary, 1971 through July, 1985. All patients were followed up for more than 6 months. Study group consists of 83 cases (Thio-tepa: 39, Adriamycin; 44) treated with topical chemotherapy following TUR during the period from January, 1978 through July, 1985. Control group consists of 33 cases treated by TUR only during the period from January 1971 through December, 1977. Following results were obtained: 1. No. of patients with recurrence; In study group, 36Pr In control group. 67% 2. Average interval of recurrence: In study group, 38 months. In control group, 30 months 3. Recurrence rate; In study group, 2.58 In control group, 3.16 4. Complication: local side effects; In TUR + Thio-tepa, 20.5% In TUR + Adriamycin, 15.9%.

Topical Therapy of Thio-TEPA on Superficial Bladder Tumors / 대한비뇨기과학회지

Intravesical thio-tepa instillations for 25 patients with superficial bladder tumors were evaluated postoperatively to reconfirm its usefulness as a prophylactic agent. The over-all recurrence rate to prophylactic thio-tepa was 28%, with minor toxicity observed in 32% of the Cases. Thio-tepa Can be given safely in the postoperative period and is effective in decreasing the recurrence rate and prolonging interval free of disease of superficial bladder tumors.

Topical Therapy of Thio-TEPA on Superficial Bladder Tumors / 대한비뇨기과학회지

Intravesical thio-tepa instillations for 25 patients with superficial bladder tumors were evaluated postoperatively to reconfirm its usefulness as a prophylactic agent. The over-all recurrence rate to prophylactic thio-tepa was 28%, with minor toxicity observed in 32% of the Cases. Thio-tepa Can be given safely in the postoperative period and is effective in decreasing the recurrence rate and prolonging interval free of disease of superficial bladder tumors.

Prophylactic Treatment of Bladder Tumors by Thio-TEPA Instillations (II) / 대한비뇨기과학회지

Study group consists of 30 cases whose follow-up period is over 6 months among 32 cases of bladder tumors treated with thio-TEPA instillation following TUR during the period from January, 1978 through June, 1981. Control group consists of 25 cases whose follow-up period is over 6 months among 33 cases of bladder tumors treated by TUR only during the period from January, 1971 through December, 1977. Following results were obtained: 1. Recurrence rate: In study group, 30% In control group, 64% 2. Interval between TUR & the first recurrence: In study group, average 8.1 months In control group, average 7.1 months 3. Number of tumors at first recurrence: In study group: 89%: under 2 11%: over 3 In control group: 25%: under 2 75%: over 3

Prophylactic Treatment of Bladder Tumors by Thio-TEPA Instillations / 대한비뇨기과학회지

Clinical observation was male on 20 cases of bladder tumors treated by thio-TEPA instillations fo1lowing TUR during the period from January, 1978 through September, 1979 and the following results were obtained. Among 20 cases of bladder tumor. 1) 7cases have been followed up without recurrence. 2) 4 cages have been followed up without recurrence with instillations, who had previous recurrences following T.U.R. only. 3) 4 cases recurred in spite of 4 thio-TEPA instillations. 4) 5 cases were not followed up sufficiently.