title: Combining Mitomycin C and Regional 70 MHz Hyperthermia in Patients with Nonmuscle Invasive Bladder Cancer: A Pilot Study.
abstract: OBJECTIVE
  Despite intravesical therapy with immunotherapy or chemotherapy intermediate and high risk nonmuscle invasive bladder cancer is associated with a high risk of recurrence and progression to muscle invasive bladder carcinoma. While intravesical hyperthermia combined with mitomycin C has proved effective to treat nonmuscle invasive bladder cancer, there is less experience with invasive regional 70 MHz hyperthermia and mitomycin C. Therefore, we examined the safety and feasibility of this treatment combination for intermediate and high risk nonmuscle invasive bladder cancer.
  
  
  METHODS
  Between 2009 and 2011, 20 patients with intermediate and high risk nonmuscle invasive bladder cancer were treated with intravesical mitomycin C (40 mg) combined with regional hyperthermia. Treatment consisted of 6 weekly sessions followed by a maintenance period of 1 year with 1 hyperthermia-mitomycin C session every 3 months. Regional hyperthermia was administered using a 70 MHz phased array system with 4 antennas. Toxicity was scored using CTC (Common Toxicity Criteria) 3.0.
  
  
  RESULTS
  The records of 18 of 20 patients could be analyzed. Median followup was 46 months. Of the 18 patients 15 (83%) completed the induction period of 6 treatments. Four patients (22%) discontinued treatment because of physical complaints without exceeding grade 2 toxicity. Toxicity scored according to CTC 3.0 was limited to grade 1 in 43% of cases and grade 2 in 14%. Mean T90 and T50 bladder temperatures were 40.6C and 41.6C, respectively. The 24-month recurrence-free survival rate was 78%.
  
  
  CONCLUSIONS
  Treatment with regional hyperthermia combined with mitomycin C in patients with intermediate and high risk nonmuscle invasive bladder cancer is feasible with low toxicity and excellent bladder temperatures.
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands. Electronic address: e.d.geijsen@amc.uva.nl.
authors.forename: Elisabeth D
authors.initials: ED
authors.lastname: Geijsen
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Theo M
authors.initials: TM
authors.lastname: de Reijke
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Caro C
authors.initials: CC
authors.lastname: Koning
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Zum Vörde Sive Vörding
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jean J
authors.initials: JJ
authors.lastname: de la Rosette
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Coen R
authors.initials: CR
authors.lastname: Rasch
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Os
authors.affiliation: Departments of Radiation Oncology and Urology (TMdR, JJdlR), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Crezee
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009361:Neoplasm Invasiveness; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin
keywords: adverse effects; hyperthermia; induced; local; mitomycin; neoplasm recurrence; urinary bladder neoplasms