A controlled study of intravesical epirubicin with or without alpha2b‐interferon as prophylaxis for recurrent superficial transitional cell carcinoma of the bladder

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Abstract
Objectives To evaluate the efficacy of intravesical epirubicin with or without alpha2b‐interferon (alpha2b‐IFN) as a prophylactic treatment for recurrent superficial transitional cell carcinoma (TCC) of the urinary bladder.Patients and methods A total of 81 patients with superficial (stage Ta and T1), well or moderately differentiated (grades 1 and 2) TCC were treated between June 1988 and December 1993. The patients were randomized into three groups: Group 1 was treated by transurethral resection (TUR) alone; Group 2 received 50 mg epirubicin and Group 3 received 50 mg epirubicin combined with 10 MU alpha2b‐IFN, intravesically in 50 mL sterile buffer solution. The instillations were started 1 week after TUR and were performed weekly during the first month and then once a month for one year. The patients were followed for a total of 2 years. Recurrence rate and tumour rate were calculated to assess the behaviour of the disease.Results The patients were followed for a mean of 20 months. Patients receiving intravesical chemoimmunotherapy (Group 3) had the most favourable outcome; they had comparatively lower recurrence and tumour rates, fewer patients with recurrences and, most importantly, the longest disease‐free interval. Side‐effects were mostly mild and transient, and no differences were found among the groups.Conclusions In reducing the number of patients having recurrences and extending the recurrence‐free interval, intravesical chemoimmunotherapy with epirubicin and alpha2b‐IFN had a promising effect on the natural course of superficial bladder cancer, particularly in patients with a history of prior recurrences.

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