title: Intravesical instillation of adriamycin in the presence or absence of verapamil for the treatment of superficial bladder cancer: preliminary report of a collaborative study.
abstract: A case-controlled collaborative study on the intravesical administration of Adriamycin in the presence or absence of verapamil, a calcium-channel blocker, as chemotherapy of superficial bladder cancer was carried out at two universities, Okayama and Kagoshima, and their affiliated hospitals. Although little is known about the expression of P-glycoprotein in superficial bladder cancer, it may be a cause of multidrug resistance (MDR). Verapamil was used as an inhibitor of P-glycoprotein. Arm A consisted of Adriamycin given at 50 mg/50 ml saline, and arm B constituted Adriamycin given at 50 mg/40 ml saline plus 5 ampules (10 ml) of injectable verapamil. The drugs were instilled into the bladder for 3 consecutive days in each of 3 consecutive weeks for a total of 9 instillations. No significant difference in antitumor effects was observed between arm A and arm B. Recurrent tumors responded better than did primary tumors to both arm-A and arm-B treatments (P = 0.012). In both treatment arms, significant differences (P = 0.031) in the response rate were found between tumors with diameters of less than 1 cm and those measuring 1-3 cm in diameter. Although the number of evaluable patients was limited, recurrent subjects who had previously received Adriamycin instillations responded in both treatment arms.
authors.affiliation: Department of Urology, Faculty of Medicine, Kagoshima University, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ohi
authors.forename: H
authors.initials: H
authors.lastname: Ohmori
authors.forename: T
authors.initials: T
authors.lastname: Shirahama
authors.forename: M
authors.initials: M
authors.lastname: Kawahara
authors.forename: Y
authors.initials: Y
authors.lastname: Matsumura
authors.forename: T
authors.initials: T
authors.lastname: Tsushima
authors.forename: Y
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003558:Cystoscopy; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D004317:Doxorubicin; D014700:Verapamil