Combination of intravesical chemotherapy and hyperthermia for the treatment of superficial bladder cancer: preliminary clinical experience.
The prevalence of superficial transitional cell carcinoma of the bladder (STCCB) is still increasing in spite of improved adjuvant chemotherapeutic and/or immunoprophylaxis approaches. Thus, there is certainly an urgent need to improve our ability to control this disease. Local hyperthermia has a therapeutical potential for the treatment of many solid tumors, especially when used in combination with other treatments, such as radiation and chemotherapy. In particular, a synergistic or, at least, supra-additive anti-tumor cell killing effect was documented when local hyperthermia was administered in combination with selected cytostatic drugs. Recently, advances in miniaturized technology have allowed the development of a system specifically designed for delivering an endovesical thermo-chemotherapy regimen in humans. In preliminary clinical experiences, insofar mainly carried out as mono-institutional investigations, the combined treatment using this system was demonstrated to be feasible, minimally invasive and safe when performed on out-patient basis. Moreover, the anti-tumoral efficacy seemed to be significantly enhanced when compared with that obtained using intravesical chemotherapy alone for both adjuvant (prophylaxis) and neo-adjuvant (ablative) approaches to superficial bladder cancer.
Colombo
R
R
Department of Urology, Vita-Salute University, Ospedale San Raffaele, Via Olgettina, 60, Milan 20132, Italy. renzo.colombo@hsr.it
Salonia
A
A
Da Pozzo
L F
LF
Naspro
R
R
Freschi
M
M
Paroni
R
R
Pavone-Macaluso
M
M
Rigatti
P
P
D000283:Administration, Intravesical; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods* / Q000639:trends; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000628:therapy*
D000970:Antineoplastic Agents