Intravesical electro-osmotic administration of mitomycin C
| Autor: | Vincenzo Pagliarulo, Francesco De Carlo, Francesco Celestino, Savino M. Di Stasi, Cristian Verri |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Electrochemotherapy medicine.medical_treatment Mitomycin 030232 urology & nephrology Urology Settore MED/24 - Urologia law.invention Cystectomy 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Refractory law Medicine Humans Urothelium Bladder cancer Antibiotics Antineoplastic business.industry Mitomycin C Cancer General Medicine medicine.disease Administration Intravesical Urinary Bladder Neoplasms 030220 oncology & carcinogenesis Electroosmosis business |
| Zdroj: | Urologia. 83(Suppl 2) |
| ISSN: | 1724-6075 |
| Popis: | Bladder cancer is very common and most cases are diagnosed as nonmuscle invasive disease, which is characterized by its propensity to recur and progress. Intravesical therapy is used to delay recurrence and progression, while cystectomy is reserved for patients who are refractory to transurethral resection and intravesical therapy. There is an increasing interest in methods to enhance the delivery of intravesical chemotherapeutic agents to improve efficacy. In vitro and in vivo studies demonstrated that electro-osmosis of mitomycin C (MMC) is more effective in delivering this drug into the urothelium, lamina propria, and superficial muscle layers of the bladder wall than is passive transport. Higher MMC tissue concentrations might have a clinical impact in the treatment of nonmuscle invasive bladder cancer (NMIBC). In randomized trials, intravesical electro-osmotic MMC was associated with superior response rate in high-risk NMIBC cancer, compared with passive diffusion MMC transport. New strategies such as intravesical Bacillus Calmette-Guerin (BCG) combined with electro-osmotic MMC as well as intravesical pre-operative electro-osmotic MMC provided promising results in terms of higher remission rates and longer remission times. Device-assisted intravesical chemotherapy may be a useful ancillary procedure in the treatment of NMIBC. Its evaluation must be planned with respect to the technical functioning of equipment and their use for a clear purpose to avoid the financial and human costs associated with incorrect therapies. |
| Databáze: | OpenAIRE |
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