[Current approaches to treatment of urinary bladder cancer]

The study included 30 patients with surface cancer of the urinary bladder stage TA-T1 G1-3. As the first step of the treatment, all the patients were operated with removal of the tumor then the patients were randomized to postoperative intravesicular immunotherapy with ronkoleucine in single doses 500,000 IU (15 patients of group 1) or 1,000,000 IU (15 patients of group 2). It was found that group 2 patients had recurrences much less frequently (26.7 vs 66.7%, respectively). With higher degrees of differentiation of the tumor cells recurrences occurred more frequently in both groups. Group 2 patients developed recurrences significantly less frequently in G1 and G2 (22.2%). In G3 all the patients had recurrences. Intravesicular administration of ronkoleukine raised absolute number of CD3 and CD4 subpopulations during the treatment and after it as well as raised concentration of TNF. The levels of the latter in the urine rose after the end of each immunoprophylaxis course. Intravesicular use of ronkoleukine entailed no specific toxic reactions. Thus, intravesicular prophylactic immunotherapy of recurrent surface cancer of the urinary bladder with ronkoleukine in a single dose 1,000,000 IU is effective prevention in patients with high (G1) and moderate (G2) grade of tumor cell differentiation. The single dose 500,000 IU is uneffective. A rise in subpopulations CD3, CD4 and TNF cytokine in the urine evidences for systemic activation of the immunity.