title: Superficial bladder cancer: the response of a marker tumour to a single intravesical instillation of epirubicin.
abstract: OBJECTIVE
  To determine the response of a marker tumour to a single instillation of intravesical epirubicin.
  
  
  METHODS
  Eighty-one patients (54 men, 27 women) with a mean age of 69.3 years (range 36-92) with superficial bladder cancer were randomized to receive a single instillation of intravesical epirubicin. At the initial cystoscopy all but one papillary marker tumour was resected. Subsequently the patients were randomized to receive either intravesical epirubicin at a concentration of 1 mg/ml (n = 40) or 2 mg/ml (n = 41) in 50 ml of saline for 1 h. The response of the marker tumour was determined at 3 months (first check cystoscopy). The toxicity associated with both treatments was also recorded.
  
  
  RESULTS
  A complete response (no visible or microscopic bladder carcinoma) was observed in 46% (95% confidence interval (CI) 35-57%) of patients. No patient experienced systemic side-effects. Chemical cystitis and bladder irritability were the most frequent local side-effects, occurring in 15% (95% CI 8-24%) of the patients.
  
  
  CONCLUSIONS
  A single instillation of intravesical epirubicin has a demonstrable effect in superficial bladder cancer. The results compare favourably with more onerous regimes. Side-effects were minimal at 1 mg/ml and acceptable at 2 mg/ml.
authors.affiliation: Department of Urology, King's College Hospital, London, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Popert
authors.forename: J
authors.initials: J
authors.lastname: Goodall
authors.forename: M J
authors.initials: MJ
authors.lastname: Coptcoat
authors.forename: P M
authors.initials: PM
authors.lastname: Thompson
authors.forename: M K
authors.initials: MK
authors.lastname: Parmar
authors.forename: J R
authors.initials: JR
authors.lastname: Masters
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D015251:Epirubicin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D015251:Epirubicin