Intravesical High Dose 5-Fluorouracil Instillations Combined with Allopurinol—A Therapeutic Alternative in the Treatment of Multiple Bladder Tumors

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Abstract
Chemical cystitis and systemic toxic effects limit the therapeutic use of intravesical cytotoxic agents against bladder tumors. In this series 1000 mg 5-fluorouracil could be instilled 2 h daily, 5 days/wk for 5 wk if 100 mg allopurinol were given 3 times daily simultaneously. After 6 weeks all patients were macroscopically free of tumors. Another instillation was performed because of recurrences within 6 mo. in 3 patients. This preliminary report of 5 patients with multiple superficial transitional cell bladder tumors shows that a combined treatment of high dose 5-fluorouracil instillation and simultaneous oral allopurinol will abolish temporarily all tumor tissue without signs of general absorption or chemical cystitis. The observation time is too short to predict definitive cure.