Bladder Cancer Responds Best to Dual Therapy
Reuters Health
NEW YORK (Reuters Health) - Applying local microwave heat therapy at the same time mitomycin C is administered is better than chemotherapy alone in preventing the recurrence of superficial bladder cancers following surgery, new study findings indicate.
Even after bladder surgery and chemotherapy or immune therapy, there is a high rate of recurrence of transitional cell carcinoma (TCC) of the bladder, Dr. Renzo Colombo and colleagues report in the Journal of Clinical Oncology. They note that thermotherapy has been shown to be safe and effective as an alternative to surgical removal of the bladder.
Colombo, at University Vita-Salute in Milan, Italy, and associates enrolled 83 patients with primary superficial TCC or recurrent TCC following surgical removal of the bladder.
Forty-one patients were randomly assigned to treatment with mitomycin C alone and 42 to thermotherapy using the Synergo 101-1 system (Medical Enterprises, Amsterdam) plus mitomycin C.
Patients underwent an induction cycle of eight weekly sessions. These were followed by a maintenance regimen of four monthly sessions, in which mitomycin C was administered for one hour, with or without thermotherapy.
Among the 75 remaining patients who completed the two-year study, there were 25 recurrences in the chemo-only group and six in the combination group.
Patients who underwent thermotherapy experienced more pelvic pain during treatment, but none of the patients dropped out of the study because of pain.
In an accompanying editorial, Dr. Donald L. Lamm notes that thermotherapy plus chemotherapy "may represent a major improvement in the management of superficial bladder cancer."
Lamm, a urologist at Mayo Clinic in Scottsdale, Arizona, notes that current optimal chemotherapy techniques were not administered in this study, so it remains to be seen how combining hyperthermia with best practice will ultimately impact the outcome of patients with superficial bladder cancer.
SOURCE: Journal of Clinical Oncology, December 2003.
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