Intracavitary Epodyl for multiple non-invasive, highly differentiated bladder tumours

Area of Science:

• Urology
• Oncology
• Pharmacology

Background:

• Recurrent bladder cancer poses a significant clinical challenge.
• Intravesical therapies are a standard treatment modality for non-muscle-invasive bladder cancer.
• Ethoglucid (Epodyl) is an alkylating agent with potential antineoplastic properties.

Purpose of the Study:

• To evaluate the efficacy and safety of intravesical ethoglucid for treating multiple, recurrent bladder cancer (Grade I-II WHO, Stage T1 UICC).

Main Methods:

• A cohort of 39 patients with recurrent bladder cancer received intravesical ethoglucid instillations.
• Treatment adherence and outcomes, including tumor eradication and recurrence rates, were monitored.
• Adverse events, particularly cystitis and myelosuppression, were recorded.

Main Results:

• Twenty-seven out of 29 patients (93%) who completed the therapeutic schedule achieved tumor eradication.
• Nine patients on prophylactic treatment remained recurrence-free for a mean of 37 months (range 18-60 months).
• No cases of myelosuppression were observed, but cystitis occurred frequently, often necessitating treatment withdrawal.

Conclusions:

• Intravesical ethoglucid demonstrates high efficacy in eradicating recurrent bladder tumors.
• Prophylactic intravesical ethoglucid can significantly reduce tumor recurrence.
• Cystitis is a significant adverse event that requires careful management during ethoglucid therapy.