PURPOSE: A prospective study was performed to compare the efficacy and safety of intravesical mitomycin C (MMC) instillation for the prophylaxis of bladder cancer at different concentrations (30 mg or 40 mg). MATERIALS AND METHODS: Ninety-seven patients that received complete transurethral resection for superficial bladder cancer were divided into two-randomized groups. One group (n=53) received 30 mg and the other group (n=44) received 40 mg dose of MMC weekly for 8 weeks, which was followed monthly for 10 months as maintenance therapy. The recurrence rates and side effects in both groups were recorded. The mean follow-up period was 32.4 months in the 30 mg group, and 32.0 months in the 40 mg group. RESULTS: The overall one and two year recurrence rates were 19% and 24% in the 30 mg group, and 12% and 22% in the 40 mg group, which was not significantly different (p>0.05). Most of the side effects were mild and transient. Moreover, the rates of the individual side effects were not statistically different in the two groups. CONCLUSION: Our comparison of 30 mg and 40 mg intravesical MMC instillation showed no difference in either response or side effects. Thus, we tentatively conclude that we can use 30 mg instead of 40 mg as an intravesical MMC instillation dose.
Administration, Intravesical* ; Follow-Up Studies ; Humans ; Mitomycin* ; Prospective Studies* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The effects of intravesical instillation of mitomycin-C(MMC) as inhibitor of development of experimental bladder tumors induced by N-butyl-N-(4-hydroxybutyl) nitrosamine(BBN) were morphologically studied. BBN was administered for 12 weeks orally and then MMC was instilled intravesically once a week with different concentration of 2 mg/ml and 5 mg/ml and doses of 4 and 8 times. There was a significant reduction in incidence if papilloma in group V which received MMC 2 mg/ml for 8 times and also there were significant reductions in incidence of carcinoma in all MMC treated groups except group III which received MMC 2 mg/ml for 4 times. These results indicate that intravesical instillation of MMC is an effective method to prevent bladder carcinogenesis. The ultrastructural effects of MMC were studied by transmission electron microscope. Partial nucleolar fragmentation and decrease in number and height of the surface microvilli of tumor cells resulting in overall increase in intercellular space and cellular detachment from the tumor surface might have played a role in reduction of cancerincidence.
Administration, Intravesical ; Animals ; Carcinogenesis ; Extracellular Space ; Incidence ; Microvilli ; Mitomycin* ; Papilloma ; Rats* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The effects of intravesical instillation of mitomycin-C(MMC) as inhibitor of development of experimental bladder tumors induced by N-butyl-N-(4-hydroxybutyl) nitrosamine(BBN) were morphologically studied. BBN was administered for 12 weeks orally and then MMC was instilled intravesically once a week with different concentration of 2 mg/ml and 5 mg/ml and doses of 4 and 8 times. There was a significant reduction in incidence if papilloma in group V which received MMC 2 mg/ml for 8 times and also there were significant reductions in incidence of carcinoma in all MMC treated groups except group III which received MMC 2 mg/ml for 4 times. These results indicate that intravesical instillation of MMC is an effective method to prevent bladder carcinogenesis. The ultrastructural effects of MMC were studied by transmission electron microscope. Partial nucleolar fragmentation and decrease in number and height of the surface microvilli of tumor cells resulting in overall increase in intercellular space and cellular detachment from the tumor surface might have played a role in reduction of cancerincidence.
Administration, Intravesical ; Animals ; Carcinogenesis ; Extracellular Space ; Incidence ; Microvilli ; Mitomycin* ; Papilloma ; Rats* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: We analyzed the impact of immediate intravesical mitomycin C instillation after transurethral resection of the bladder (TURB) on tumor recurrence and progression in patients with periodic mitomycin C instillation. MATERIALS AND METHODS: Between June 2000 and June 2006, a retrospective study was performed in a total of 115 patients with primary bladder tumors receiving a 6-week course of mitomycin C instillation after TURB. The patients were assigned to two groups: 53 patients in the immediate mitomycin C (I-MMC) group were treated by immediate instillation of mitomycin C after TURB and periodic instillation (6 times, 1 time per week), and 62 patients in the MMC group received only periodic instillation. Tumor recurrence and progression were compared in the two groups. RESULTS: During the mean follow-up period of 46.5 months in the I-MMC group and 47.2 months in the MMC group, early recurrence (within 1 year) occurred in 6 of 53 patients (11.3%) in the I-MMC group and in 18 of 62 patients (29.0%) in the MMC group (p<0.02). Although a significantly lower early recurrence rate was observed in the I-MMC group, this difference was not significant for recurrence within 2 or 3 years or for total recurrence. Progression was not significantly different between the two groups regarding the early and total period. CONCLUSIONS: Our study confirmed the positive effect of a single, immediate mitomycin C instillation in patients with non-muscle-invasive bladder tumors who received periodic mitomycin C instillation. This benefit was limited to early recurrence and was not maintained with long-term follow-up. This approach can be an alternative to periodic mitomycin C instillation without immediate instillation.
Administration, Intravesical ; Follow-Up Studies ; Humans ; Mitomycin ; Recurrence ; Retrospective Studies ; Urinary Bladder ; Urinary Bladder Neoplasms

Animals ; Chemoembolization, Therapeutic ; Drugs, Chinese Herbal ; administration & dosage ; Iodized Oil ; administration & dosage ; Liver Neoplasms, Experimental ; therapy ; Mitomycin ; administration & dosage ; Orchidaceae ; Phytotherapy ; Rats ; Rats, Inbred ACI

PURPOSE: To report the case of a 36-year-old patient with nanophthalmic uveal effusion was treated with scleral window surgery and topical administration of mitomycin C (MMC). CASE SUMMARY: A 36-year-old woman presented with decreased visual acuity and blurred vision in the both eyes during 3 months. Fundus examination revealed choroidal effusion and retinal detachment with thickend sclera wall and short axial lengh. Partial-thickness sclera flap with deep sclerostomy was performed and topical MMC was administered to one quadrant of the equatorial sclera. The subretinal fluid resorbed gradually and visual acuity improved. CONCLUSIONS: Scleral window surgery and topical mitomycin C might relieve the blocked transscleral outflow of intraocular fluid in the small area of a sclerostomy in young patient with nanophthlamos.
Administration, Topical ; Adult ; Aqueous Humor ; Choroid ; Eye ; Female ; Humans ; Mitomycin ; Retinal Detachment ; Sclera ; Sclerostomy ; Subretinal Fluid ; Vision, Ocular ; Visual Acuity

A total or 56 patients who underwent TUR-BT for superficial (stages O and A) bladder tumors received various chemoprophylactic treatment to prevent recurrence. 16 patients underwent resection only (Group I). Of the 56 patients treated with chemoprophylactic agents 18 patients were given thio-tepa at weekly interval for 8 weeks (Group 2). 20 patients were given adriamycin. weekly one time for 6 weeks (Group 3). 16 patients were given mitomycin C, weekly one time for 8 weeks (Group 4). All chemoprophylactic groups were followed by monthly one time for 1 year and the dosages of the used agents (thio-tepa, adriamycin and mitomycin C) were 60 mg/l dosage, 50 mg/l dosage and 30 ml/l dosage, respectively. During follow-up period (mean duration; 19.8-25. 2 months), 1umor recurred 56.2 % of group 1 patients, 27.7 % of group 2 patients, 25.0% of group 3 patients, 18.9 % of group 4 patients and 22.2% of total patients. Therefore three drugs were effective to decrease the recurrence rate of superficial bladder tumor and no significant differences in recurrence rate were noticed among drugs. Toxicity of the three agents were negligibly minimal except 2 patients who developed severe gross hematuria after adriamycin instillation.
Administration, Intravesical* ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Hematuria ; Humans ; Mitomycin ; Recurrence ; Robenidine* ; Thiotepa ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Mitomycin C is an antibiotic isolated from the broth of Streptomyces caespitosus which has been used as the adjunctive drug to reduce the fibroblast proliferation. Holmium laser sclerostomy can minimize conjunctival damage. We examined pharmacokinetics of mitomycin C following topical administration. Holmium laser sclerostomy was performed on one eye of each 15 rabbits and the other eye was served as a control. Next day, mitomycin C solution(0.4mg/ml) was administered by topical drops in both eyes of each rabbit. The concentrations of mitomycin C in the aqueous and the vitreous compartments of operated and control eyes were determined by HPLC at 0.5, 1, 2, 3, 6 hours after topical administration. The peak aqueous concentration was 0.07 microgram/ml in operated eyes and 0.06 microgram/ml in control eyes. The peak vitreous concentration was 0.10 microgram/ml in operated eyes and 0.09 microgram/ml in control eyes. The levels of detected mitomycin C at all time intervals were higher than the IC50(0.002 microgram/ml) for the inhibition of conjunctival fibroblast proliferation. These results suggest that topical mitomycin C easily crosses the intact and minimally damaged conjunctiva and therefore increases the success rate of Holmium laser sclerostomy.
Administration, Topical ; Chromatography, High Pressure Liquid ; Conjunctiva ; Fibroblasts ; Holmium* ; Lasers, Solid-State* ; Mitomycin* ; Pharmacokinetics ; Rabbits* ; Sclerostomy* ; Streptomyces

OBJECTIVETo evaluate the clinical efficacy of capecitabine combined with transcatheter arterial chemoembolization (TACE) for advanced liver cancer.

METHODSForty-nine patients with liver cancer were retrospectively divided into two groups: Treatment group, on the basis of TACE, 23 patients received oral capecitabine at 2500 mg/m(2), twice-daily for 14 days followed by 7-day rest period and repeated in every three week intervals for more than two cycles. Control group, 26 patients received TACE only at 2-month intervals for at least two cycles.

RESULTSIn capecitabine and TACE group: there were 1 CR, 14 PR, 5 SD and 3 PD; the overall response rate was 65.2%; the AFP and tumor reduction rates were 68.8% and 73.9%; the median survival time was 11.9 months. In the TACE only group: there were 0 CR, 7 PR, 12 SD and 7 PD; the overall response rate was 26.9%; the AFP and tumor reduction rates were 31.6 % and 30.8%; the median survival time was 8.3 months. The most common side-effects of capecitabine were hand-foot syndrome and diarrhea.

CONCLUSIONCapecitabine combined with TACE is safe and effective for advanced liver cancer.

Administration, Oral ; Adult ; Aged ; Antimetabolites, Antineoplastic ; administration & dosage ; Capecitabine ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Drug Administration Schedule ; Female ; Fluorouracil ; analogs & derivatives ; Humans ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage

We studied the efficacy and safety of using topical mitomycin C (MMC) as an adjunct to glaucoma filtration surgery. Trabeculectomy was performed in 23 eyes of 19 patients with poor surgical prognosis. After the preparation of a scleral flap, 0.2 mg or 0.4 mg/ml MMC was applied to the exposed tissue for 5 minutes. The wound was then irrigated with 250ml of normal saline. The mean follow-up period was 7.8 months. Preoperative mean intraocular pressure (IOP) was 33.8mmHg, and the mean IOPs on 1, 3, 6, and 12 months after operation were 10.3, 12.5, 12.4 and 12.3mmHg, respectively. At postoperative 12 months, 74.7% achieved an IOP of less than or equal to 20mmHg without any antiglaucoma medication. There were early postoperative complications of aqueous leaking from conjunctival wounds in 3 eyes (13.0%), shallow anterior chamber in 2 eyes, and hyphema in one eye and one eye had long-term hypotony lasting more than 3 months. Although MMC is simple to use, it is a potent adjunct to glaucoma filtration surgery, more work should follow to determine the mechanism of action, indications, dosage and optimal exposure time of MMC.
Administration, Topical ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Glaucoma/surgery/*therapy ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Ophthalmic Solutions ; Prognosis ; *Trabeculectomy