Features of Treatment of the Patients with Superficial Bladder Cancer when there are Anomalies in its Development
About the author:
Kostiuk O. G.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Introduction. At the moment of consultation in about 75-80% of the patients the urinary bladder cancer was localized in the mucous membrane or in the submucous layer of the urinary bladder. Absence of a common view as to the accuracy of diagnostics of the superficial bladder cancer (SBC) led to occurrence of a large number of methods for its treatment. Available methods do not provide confidence in successful treatment of the cancer and prevention of its recurrence that is in our opinion due to lack of morphological studies concerning changes of the epithelium and submucous layer of the urinary bladder. Research objective. To determine influence of steady concentration of the chemotherapy drug on the bladder superficial tumor in the patients having anomalies of its development. Research subject and methods. The search for new approaches to treatment of superficial bladder cancer es-pecially those connected with the anatomic deviations in the urinary bladder structure led to introduction of a new method for the SBC treatment directed at maintenance of steady concentration of the chemotherapy drug in the cavity of the urinary bladder (Ukrainian Patent No. 88097). The main point of the invention is that the Doxorubicin or Mitomycin C solution with the concentration of 0. 2% is administered into the urinary bladder constantly during one hour or a period determined for the treatment pro-cedure. The steady volume and steady concentration of the chemotherapy drug is regulated by drip urine diversion and drop infusion of the drug allowing to keep equal administration of the solutions of urine and medicinal prepara-tion and to provide diversion of their mixture in equal volumes. Research results and their discussion. According to this method of the anti-tumor drug administration the Doxo-rubicin solution of the determined concentration was used. Under the clinical conditions of Vinnitsa Regional Clini-cal Oncologic Dispensary 18 patients with the SBC were treated during 2008-2010. The examinations of the urinary bladder performed 3 months later including cystoscopy, ultrasonic examination of the urinary bladder, urine cytological examination for atypical cells and occult blood in all the cases showed no tumor recurrence. The patients’ general state remained satisfactory, there were no complaints of dysuria. It also should be mentioned that during cystoscopy there were no inflammation signs in the patients to whom this admin-istration method had been applied. Thus application of the new method allowed to maintain steady concentration of the chemotherapy drug in the patients with deviations of the anatomic structure of the urinary bladder and with inflammatory processes therein and to prevent recurrence in these patients during the early postoperative period. The analysis of the SBC treatment and clinical course of the postoperative period while using this method in 18 patients allowed to prevent early disease recurrences after its use in 16 patients. There were no long-term abnor-malities of the reservoir and excretory function observed that proved adequacy of treatment for the patients with the SBC by means of the chosen method. The disease recurred in two patients after 1,5 years. Conclusions. So, taking into account that according to the literature data early recurrences are considered to be dangerous in terms of the disease progression and occurrence of invasive forms of the urinary bladder cancer that greatly deteriorate the life quality the method proposed by us maintains steady concentration of the chemotherapy drug in the cavity of the urinary bladder and has the following advantages: The number of early recurrences in the patients treated by the methods proposed by us (the “dry” urinary bladder) makes up 8,8% against 40-70% stated in the literary sources (p<0,001). The methods for creation of the “dry” urinary bladder and maintenance of steady concentration of the chemotherapy drug in the cavity of the urinary bladder when there are anomalies in its development imply single postoperative administration of the chemotherapy drug as compared to 6-10 ones stated in the literature that considerably reduces the cost of the treatment process and makes it more efficient and reliable.
superficial cancer of urinary bladder, treatment.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 part 3 (109), 2014 year, 143-146 pages, index UDK 616-007:616. 62-006. 6-08