Local instillation of Thio-tepa (triethylene thiophosphoramide) is widely used as an important adjunct in the management of papilloma of the bladder. We herein report the 10 case of the bladder cancer administered with Thio-tepa for the treatment and prophylaxis.
Administration, Intravesical* ; Papilloma ; Thiotepa* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

We compared the prophylactic efficacy of intravesical BCG with thiotepa instillation after complete removal of superficial bladder cancer. Forty patients received BCG and 32 received thiotepa. The mean followup period was 29 months in BCG group, and 34 months in thiotepa group. The overall recurrence rate was 35% in BCG group compared with 53% in thiotepa group, showing difference statistically(p<0.05) The mean time to recurrence was 8.7 months in BCG group, and 7.2 months in thiotepa group(p>0.05). The overall recurrence index per 100 patient-months was also lower for the BCG versus the thiotepa group(1.21 versus 1.56, p>0.05). One patient in the BCG group and 4 in the thiotepa group had recurrent tumors with progression in stage. Side effects were irritative voiding symptoms(100%), fever and chills(10%), and inguinal lymphadenitis(2.5%) in BCG group, while irritative voiding symptoms(25%), fever and chills(6.3%), and myelosuppression (6.3%) in thiotepa group. Our results suggest that BCG is significantly superior to thiotepa in reducing bladder tumor recurrence and in retarding tumor progression.
Administration, Intravesical* ; Bacillus* ; Fever ; Follow-Up Studies ; Humans ; Mycobacterium bovis ; Recurrence ; Thiotepa* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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*

A clinical observation was made on 236 cases of bladder tumor admitted to the Department of Urology, Presbyterian Medical Center during the period from August, 1970 through July, 1980 and the following results were obtained. 1. Among 236 cases of in-patients, 188 cases were male and 48 female with 4:1 ratio. 2. Main age distribution was between 40 and 70 years, showing the highest incidence in 60 to 69 years (33. 1%). 3. The clinical manifestation included hematuria (81.4%), dysuria (27. 6%), frequency(24. 6%) and other symptoms. 4. The tumors were located in the base and lateral wall of bladder (67%) mainly. 5. On I. V. P. findings, 135 cases(57. 2%) were normal, 40 cases (17. 0%) showed unilateral hydronephrosis and 14 cases (6.0%) bilateral hydronephrosis. 5. Of 235 cases of bladder tumor, 181 (76.6%) were transitional cell carcinoma, 10 cases (4.3%) of squamous cell carcinoma and 4 cases of adenocarcinoma (1. 7%). 7. On treatment of bladder tumor, T. U. R. was performed on 122 cases, total cystectomy 57. radiation therapy 33 and thio-TEPA bladder instillation 28.
Adenocarcinoma ; Administration, Intravesical ; Age Distribution ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Cystectomy ; Dysuria ; Female ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Male ; Protestantism ; Thiotepa ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

In a prospective study without crossover design, we were to compare the efficacy of Thiotepa and Mitomycin C when each was instilled intravesically after complete transurethral resection of all visible superficial bladder cancer(stage Ta, Tis and Tl) in 89 consecutive patients. The 3-months and 1year rates free of recurrence were 85.7 and 82.1 percent, respectively for Thiotepa(28 patients), 86.4 and 81.8 percent for Mitomycin C(22 patients), and 79.5 and 56.4 percent for control group(39 patients). Although Thiotepa intravesical instillation demonstrated effectiveness slightly superior to that of Mitomycin C, no significance difference in recurrence and progression rate was noted for either drug group. No patient required discontinuation of therapy in either group because of toxicity although 3 patients required temporary discontinuation of therapy secondary to myelosuppression (2) and symptomatic cystitis(1) in Thiotepa group, and 5 patients secondary to symptomatic cystitis(3) and rash or contact dermatitis(2) in mitomycin C group. This results suggest that Thiotepa is more useful and effective than Mitomycin C for the prophylactic treatment of superficial bladder tumor in cost saving, acceptable toxicity and patients`s convenience, in addition to decreasing the recurrence rate.
Administration, Intravesical* ; Cost Savings ; Cross-Over Studies ; Drug Therapy ; Exanthema ; Humans ; Mitomycin* ; Prospective Studies ; Recurrence ; Thiotepa* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The feasibility and effectiveness of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) were evaluated in children younger than 3 yr of age with atypical teratoid/rhabdoid tumors (ATRT). Tandem HDCT/autoSCT was administered following six cycles of induction chemotherapy. Radiotherapy (RT) was administered if the tumor relapsed or progressed, otherwise, it was administered after 3 yr of age. Tumors relapsed or progressed during induction chemotherapy in 5 of 9 patients enrolled; 3 of these 5 received tandem HDCT/autoSCT as a salvage treatment. One patient died from sepsis during induction chemotherapy. The remaining 3 patients proceeded to tandem HDCT/autoSCT; however, 2 of these patients showed tumor relapse/progression after tandem HDCT/autoSCT. All 7 relapses/progressions occurred at primary sites even in patients with leptomeningeal seeding. Toxicities during tandem HDCT/autoSCT were manageable. A total of 5 patients were alive with a median follow-up of 20 (range 16-70) months from diagnosis. Four of 5 patients who received RT after relapse/progression are alive. The probability of overall survival at 3 yr from diagnosis was 53.3% +/- 17.3%. Our tandem HDCT/autoSCT is feasible; however, early administration of RT prior to tandem HDCT/autoSCT should be considered to improve the outcome after tandem HDCT/autoSCT.
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carboplatin/administration & dosage ; Central Nervous System Neoplasms/drug therapy/radiotherapy/*therapy ; Child, Preschool ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Etoposide/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Infant ; Male ; Prospective Studies ; Recurrence ; Rhabdoid Tumor/drug therapy/radiotherapy/*therapy ; Salvage Therapy ; *Stem Cell Transplantation ; Survival Rate ; Thiotepa/administration & dosage ; Transplantation, Autologous

BACKGROUND: The long-term survival of patients with non-Hodgkin's lymphoma after conventional chemotherapy is about 35%, with the remaining 65% of patients tending to be refractory or experience relapse. As such, primary refractory patients responding to salvage chemotherapy, and sensitive relapsed patients and primary high- risk patients are recommended to receive high-dose chemotherapy (HDC) and autologous peripheral blood stem cell transplantation (PBSCT). We evaluated the role of HDC and autologous PBSCT in patients with primary refractory, primary high risk, and sensitive relapsed non-Hodgkin's lymphoma. METHODS: We performed a retrospective analysis of the data from 50 patients with non-Hodgkin's lymphoma who were treated with HDC and autologous PBSCT in the Catholic Hematopoietic Stem Cell Transplantation Center between 1997 and 2002. RESULTS: Of the 50 patients, the conditioning regimen was BEAM in 20, CMT (cyclophosphamide, melphalan and thiotepa) in 19, fludarabine- and total body irradiation (TBI) -based regimen in 8, and cyclophosphamide and TBI in 2. There were 3 (6%) deaths due to treatment-related toxicity within the first 50 days after transplantation. Twenty-five patients remain alive at a median follow-up duration of 40.5 months (range 9~61). Among the patients with partial response before transplantation, 76% showed further response after transplantation. In half of these responders, the disease state was changed into complete response (CR) after transplantation. 2-year overall survival was 52% and 2-year progression free survival was 36.8%. Median overall survival was 34 months (range 8~60), and median progression-free survival was 8 months (range 1~14). Median overall survival was 14 months (range 9~19) in the primary high-risk group (n=13), 7 months (range 4~10) in the resistance relapse group (n=5), and 6 months (range 0~14) in the primary refractory group (n=10). Overall survival in the sensitive relapse group (n=22) did not reach the median; the mean overall survival in this group was 33 months. The disease status before transplantation was the only significant prognostic factor in determining overall survival (p=0.032) and progression- free survival (p=0.001). CONCLUSION: HDC and autologous PBSCT appears to produce high response rate. Primary high-risk group and sensitive relapse group had good prognosis, while refractory and resistance relapse group had poor prognosis. And the pre-transplantation disease status was the only significant prognostic factor in multivariate analysis.
Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse effects/*therapeutic use ; Chemotherapy, Adjuvant ; Cyclophosphamide/administration & dosage ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin/drug therapy/radiotherapy/surgery/*therapy ; Male ; Melphalan/administration & dosage ; Middle Aged ; Neoplasm Recurrence, Local/drug therapy/radiotherapy/surgery/*therapy ; Retrospective Studies ; *Stem Cell Transplantation ; Survival Analysis ; Thiotepa/administration & dosage ; Transplantation Conditioning/methods ; Transplantation, Autologous ; Treatment Outcome ; Vidarabine/administration & dosage/analogs & derivatives ; *Whole-Body Irradiation

Chemotherapy plays an important role in the treatment of metastatic breast cancer. It is important to monitor chemotherapeutic efficacy, to find a simple and efficient tool to guide treatment, and to predict the efficacy of treatment in a timely and accurate manner. This study aimed to detect mucin-1 (MUC1)-positive circulating tumor cells and MUC1 protein in the peripheral blood of patients with metastatic breast cancer and to investigate their relationship to chemotherapeutic efficacy. MUC1 mRNA was detected in the peripheral blood of 34 patients with newly diagnosed metastatic breast cancer by reverse transcription-polymerase chain reaction. The positive rates of MUC1 mRNA were 88.2% before chemotherapy and 70.6% after chemotherapy, without a significant difference (P=0.564); MUC1 mRNA expression before chemotherapy had no correlation with treatment effectiveness (P=0.281). The response rate of MUC1 mRNA-negative patients after first-cycle chemotherapy was significantly higher (P=0.009) and the progression-free survival (PFS) was clearly longer than those of MUC1 mRNA-positive patients (P=0.095). MUC1 protein in peripheral blood plasma was detected by an ELISA competitive inhibition assay. The patients with decreased MUC1 protein after chemotherapy had a significantly longer PFS than those with elevated MUC1 protein (P=0.044). These results indicate that the outcomes of MUC1 mRNA-negative patients after chemotherapy are better than those of MUC1 mRNA-positive patients. In addition, patients with decreased expression of MUC1 protein have a better PFS.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; drug therapy ; secondary ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Cell Line, Tumor ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; Lymphatic Metastasis ; Middle Aged ; Mucin-1 ; blood ; genetics ; metabolism ; Neoplastic Cells, Circulating ; metabolism ; RNA, Messenger ; metabolism ; Receptors, Progesterone ; metabolism ; Taxoids ; administration & dosage ; Thiotepa ; administration & dosage