[Instillation chemotherapy with peplomycin in superficial bladder cancer: clinical study on the effects of the direct antitumor activity and of the prophylaxis of recurrence].

Two kinds of clinical studies for intravesical instillation chemotherapy of peplomycin (PEP) were carried out, one to evaluate the direct antitumor activity in superficial bladder cancer (study I), and the other to evaluate the prophylactic effect on recurrence of bladder cancer after transurethral resection (study II). In study I, 22 patients with low stage bladder cancer were entered, and 16 of them were eligible for evaluation of efficacy. Twelve patients were treated twice a week with intravesical instillation of 20 mg of PEP/20 ml of saline for 4 weeks. Four patients were treated in the same way with 40 mg of PEP/20 ml of saline. Among the patients treated with 20 mg of PEP, two showed complete remission and one showed partial remission. Of the patients treated with 40 mg of PEP, one showed partial remission. Thus, the overall response rate was 25%. The tumors of the two complete responders were so tiny that they might have been damaged mechanically by the biopsy forceps. Therefore, we considered that the instillation chemotherapy of PEP at a dose of 20 or 40 mg/20 ml of saline had little effect on superficial bladder cancer. In study II, we performed a randomized trial designed to compare the recurrence rate after transurethral resection (TUR) alone with that after TUR followed by prophylactic instillation of PEP. Ninety-four patients newly diagnosed as having low stage bladder cancer were entered in the study. They were divided into three groups after TUR. Group A consisted of 38 patients who were treated with weekly instillation of 20 mg of PEP/20 ml of saline for 8 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)