The treatment of bladder tumors by the intravesical instillation of thio-TEPA or of actinomycin D

ABSTRACT

Thio-TEPA weekly instillations of 30-60 mg. in 30-60 ml. of sterile water or saline were employed in 20 patients with bladder papilloma or various stages of bladder carcinoma. Two of 6 patients with papilloma showed complete disappearance of the tumor after an average of 8 instillations and two of six (2/6) patients with papilloma showed partial destruction of the tumor. In 10 patients with deeply infiltrating cancers practically no response was observedActinomycin D was employed in 7 patients using a weekly topical dose of 1.0 mg. in 30 ml. of sterile water or saline. In the four patients with papilloma, one showed necrotic changes without apparent decrease in size of the tumor. In no instance was disappearance of a papilloma observedAs employed in this series, topical actinomycin D instillation for bladder tumor was of no value. Topical thio-TEPA may be useful for patients who are poor surgical risks and for patients whose lesions are diffuse and not amendable to surgical attack less than a cystectomy. For solitary or few papillary tumors conventional methods of transurethral treatment are preferable. (Summary)