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Mitomycin C resorption following repeated intravesical instillations using different instillation times
P J van Helsdingen1, C H Rikken, H P Sleeboom
1Department of Urology, Leyenburg Teaching Hospital, The Hague, The Netherlands.
Urologia Internationalis
|January 1, 1988
Summary
This study on superficial bladder cancer found that mitomycin C (MMC) instillation is safe and effective. Bladder wall resorption and side effects were not affected by instillation time, with minimal systemic absorption.
Area of Science:
- Urology
- Oncology
- Pharmacology
Background:
- Superficial and/or CIS transitional cell carcinoma of the bladder requires effective intravesical therapies.
- Mitomycin C (MMC) is a chemotherapeutic agent used in intravesical instillation for bladder cancer treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of intravesical mitomycin C (MMC) following transurethral resection for superficial bladder cancer.
- To assess the influence of instillation time (0.5 vs. 1.0 hour) on MMC resorption and toxicity.
Main Methods:
- A prospective, randomized trial involving 31 patients with superficial and/or CIS transitional cell carcinoma.
- Patients underwent complete transurethral resection followed by intravesical instillation of 40 mg mitomycin C (MMC).
- MMC instillation times were randomized to 0.5 or 1.0 hour.
Main Results:
- Bladder wall resorption of MMC was not significantly influenced by the 0.5 or 1.0-hour instillation times.
- No cumulative effect on MMC resorption was observed with consecutive instillations; less than 1% of the dose was resorbed systemically.
- Maximum plasma concentration of MMC remained low (≤31 ng/ml), and observed side effects included chemical cystitis and exanthema, unrelated to instillation duration. Bone marrow toxicity was not observed.
Conclusions:
- Intravesical mitomycin C (MMC) is a safe and well-tolerated treatment for superficial bladder cancer.
- Instillation time does not impact MMC resorption or toxicity, suggesting flexibility in treatment protocols.
- The low systemic absorption and lack of bone marrow toxicity support the favorable safety profile of intravesical MMC.