Treatment of bladder cancer with intravesical instillation of adriamycin.

Intravesical treatment with adriamycin has been extensively employed in the last decade. In the treatment of carcinoma in situ complete responses have been reported in about 60% of cases. Its efficacy is probably lower in the therapy of multiple or diffuse low stage transitional cell carcinoma that is too extensive to be completely resected by conventional transurethral surgery. In such circumstances, including cancer in situ, adriamycin compares favorably with other local forms of treatment. The prophylactic use of intravesical instillation of Adriamycin has been studied more extensively. Preliminary results of controlled randomized trials implemented from the EORTC Urological Group show that adriamycin instillations significantly reduce recurrence rate after TUR. The treatment is well tolerated. Systemic absorption is virtually absent, and no severe drug-related side effects have ever been reported. Chemical cystitis is occasionally observed, especially if multiple instillations are started immediately after TUR, or in the presence of additional inflammatory conditions, such as previous irradiation or bacterial cystitis.