Intravesical hyperthermia and mitomycin-C for carcinoma in situ of the urinary bladder: experience of the European Synergo working party.
OBJECTIVE
To study the results of chemotherapy combined with intravesical hyperthermia in patients with mainly BCG-failing carcinoma in situ (CIS).


METHODS
Patients with histologically confirmed CIS were included retrospectively. Outpatient thermochemotherapy treatment was done with mitomycin-C (MMC) and the Synergo system SB-TS 101 (temperature range between 41 and 44 degrees C), weekly for 6-8 weeks, followed by 4-6 sessions every 6-8 weeks.


RESULTS
Fifty-one patients were treated between 1997 and 2005 from 15 European centers. Thirty-four were pre-treated with BCG. Mean age was 69.9 years. Twenty-four patients had concomitant papillary tumors. The mean number of hyperthermia/MMC treatments per patient was 10.0. Of the 49 evaluable patients 45 had a biopsy and cytology proven complete response. In two patients CIS disappeared, but they had persistent papillary tumors. Follow-up of 45 complete responders showed 22 recurrences after a mean of 27 months (median 22): T2 (4), T1 (4), T1/CIS (1), CIS (5), Ta/CIS (2), Ta (5) and Tx (1). Side effects (bladder complaints) were generally mild and transient.


CONCLUSIONS
In patients with primary or BCG-failing CIS, treatment with intravesical hyperthermia and MMC appears a safe and effective treatment. The initial complete response rate is 92%, which remains approximately 50% after 2 years.
Alfred Witjes
J
J
Department of Urology, Radboud University Nijmegen Medical Centre, PO Box 9101, Nijmegen 6500 HB, The Netherlands. f.witjes@uro.umcn.nl
Hendricksen
Kees
K
Gofrit
O
O
Risi
O
O
Nativ
O
O
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000628:therapy*; D003131:Combined Modality Therapy; D005060:Europe; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin