Combined thiotepa and mitomycin C instillation therapy for low-grade superficial bladder tumor

Fifteen patients with superficial low-grade bladder tumors were treated with combined thiotepa and mitomycin C instillation as definitive therapy. The amount of both thiotepa and mitomycin C used in each instillation in the presenting protocol was one half the conventional dose of either used alone. Patients with multiple bladder tumors, bladder tumors inaccessible to endoscopic resection, or lesions too extensive to completely resect, or with medial contraindications for endoscopic resection procedures, were included in these studies. No serious adverse effect was revealed in these 15 patients. Ten of the 15 patients (66.7%) had a complete response and 4 (26.7%) had a partial response. One patient (6.6%) did not respond to this regimen. This protocol seems to provide a therapeutic modality that is more effective than conventional single-drug therapy, less toxic than thiotepa used alone, and less expensive than mitomycin C used alone.