Prevention of Recurrence With Epirubicin and Lactobacillus Casei After Transurethral Resection of Bladder Cancer
Received 2 May 2007 published online 12 December 2007.
Refers to article:
Tissue Inhibitor of Metalloproteinases-3 Promoter Methylation is an Independent Prognostic Factor for Bladder Cancer
, 14 December 2007
Mohammad Obaidul Hoque, Shahnaz Begum, Mariana Brait, Carmen Jeronimo, Marianna Zahurak, Kimberly Laskie Ostrow, Eli Rosenbaum, Bruce Trock, William H. Westra, Mark Schoenberg, Steven N. Goodman, David Sidransky
The Journal of Urology
February 2008 (Vol. 179, Issue 2, Pages 743-747) Abstract |
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Purpose
A prospective, randomized, controlled trial was done to evaluate whether oral administration of a preparation of the probiotic agent Lactobacillus casei (Yakult Honsha, Tokyo, Japan) could enhance the prevention of recurrence by intravesical instillation of epirubicin after transurethral resection for superficial bladder cancer.
Materials and Methods
Between August 1999 and December 2002, 207 patients clinically diagnosed with superficial bladder cancer were included as study candidates and underwent transurethral resection, followed by intravesical instillation of 30 mg epirubicin/30 ml saline twice during 1 week. After histological confirmation of superficial bladder cancer they were again included as study participants with 102 randomized to receive treatment with 6 additional intravesical instillations of epirubicin during the 3-month period after transurethral resection (epirubicin group) and 100 randomized to intravesical chemotherapy on the same schedule as the epirubicin group plus oral administration of 3 gm Lactobacillus casei preparation per day for 1 year (epirubicin plus Lactobacillus casei group). Patients were evaluated for intravesical recurrence, disease progression, prognosis and adverse drug reactions.
Results
The 3-year recurrence-free survival rate was significantly higher in the epirubicin plus Lactobacillus casei group than in the epirubicin group (74.6% vs 59.9%, p = 0.0234), although neither progression-free nor overall survival differed between the groups. The incidence of adverse drug reactions did not significantly differ between the groups and there were no serious adverse drug reactions.
Conclusions
Intravesical instillation of epirubicin plus oral administration of Lactobacillus casei preparation is a novel, promising treatment for preventing recurrence after transurethral resection for superficial bladder cancer.
aDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
bDepartment of Medical Information on Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
cDepartment of Urology, Harasanshin General Hospital, Fukuoka, Japan
dDepartment of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
eDepartment of Urology, University of Occupational and Environmental Health, Miyazaki, Japan
fDepartment of Urology, Moji Rousai Hospital, Miyazaki, Japan
gDepartment of Urology, Kitakyushu and Miyazaki Medical College, Miyazaki, Japan
Correspondence: Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan (telephone: +81-92-642-5601; FAX: +81-92-642-5618).
Study received local institutional review board approval.
For another article on a related topic see page 743.
ABSTRACT