Intravesical methotrexate in the treatment of superficial bladder cancer

Thirty patients with superficial bladder cancer (Tis, Ta, Tl) difficult to control by endoscopic means were given a total of 49 courses of methotrexate at fortnightly intervals. Four concentrations were investigated. In 14 courses this was the sole treatment and in the remainder the methotrexate was given as prophylaxis. Toxicity was not a problem but in both groups, although there was some evidence of anti-tumour activity, there were high recurrence rates and intravesical methotrexate cannot be recommended.