[Toxicity of prophylaxis of superficial bladder tumors]

The paper reviews the various prophylaxis modalities in surface vesical tumours in order to define the degree of toxicity caused by each of them. Also, a prophylaxis diagram is prepared, having into account each substance's toxicity, the benefit awarded to each of then and the tumour prognosis. The agents under assessment are Thiotepa, Adriamycin, Epirubicin, Cisplatin, oral Methotrexate, Mitomycin-C, Mitoxantrone, Interferon and BCG, at doses of 40, 120 and 150 mg. Two groups of prophylactic agents can be identified with regard to toxicity. The first one is constituted by Interferon, Adriamycin, Epirubicin and Mitomycin-C, with side-effects lower than or close to the net benefit estimated for each. The second group comprises cytostatic and immunomodulatory compounds with toxic effects greater than their net benefit. In this group, three different situations can be distinguished: a) BCG with high toxicity and high net benefit; b) Cisplatin, Thiotepa and Mitoxantrone with high toxicity and net benefit similar to that of Adriamycin, Epirubicin and Mitomycin C; and c) Oral Methotrexate, with high toxicity and no benefit. According to their toxicity levels, Interferon, Adriamycin, Epirubicin and Mitomycin C are indicated in the prophylaxis of medium-risk tumours, while BCG only in high-risk tumours. Thiotepa, Cisplatin, Mitoxantrone and oral Methotrexate have to be eliminated due to their negative benefit-toxicity relationship.