A randomised prospective study comparing intravesical instillations of mitomycin-C, BCG-Tice, and BCG-RIVM in pTa-pT1 tumours and primary carcinoma in situ of the urinary bladder. Dutch South-East Cooperative Urological Group.
We compared intravesical instillations with mitomycin-C (MMC), Bacillus Calmette-Guerin (BCG) Tice, and BCG-RIVM in patients with pTa-pT1 papillary carcinoma and primary carcinoma in situ (CIS) of the bladder. Nine instillations with MMC were given or 6 weekly instillations with BCG. Early recurrences were treated with additional instillations. For toxicity and efficacy 437 patients were evaluated with a median follow-up of 32 months (range 12-56). Drug-induced and bacterial cystitis were the most frequent side-effects. The number and severity of side-effects (chi 2 test) were comparable in both BCG groups, but were significantly less in the MMC group for drug-induced cystitis (P = 0.009), other local side-effects (P = 0.004) and systemic side-effects (P < 0.001). The disease-free percentage (log-rank test) showed no significant difference for the three arms for papillary tumours (P = 0.08), nor the CIS (P = 0.20), although for CIS numbers are small. Additional instillations did not influence toxicity or efficacy.
Department of Urology, University Hospital, Nijmegen, The Netherlands.
J A
JA
Witjes
A P
AP
vd Meijden
W P
WP
Witjes
W
W
Doesburg
H E
HE
Schaafsma
F M
FM
Debruyne
D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000473:pathology / Q000628:therapy*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000628:therapy*; D003556:Cystitis / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D009367:Neoplasm Staging; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D001500:BCG Vaccine; D016685:Mitomycin