表阿霉素膀胱灌注预防浅表性膀胱癌术后复发的疗效观察

目的　探讨表阿霉素膀胱灌注防治浅表性膀胱癌术后复发的疗效。　方法　应用表阿霉素对 32例浅表性膀胱癌行经尿道膀胱肿瘤电切术或膀胱部分切除术后患者早期一次性膀胱腔内灌注 ,定期膀胱镜检查和随访。　结果　 32例术后随访 12～ 2 4个月 ,平均 18个月 ,4例于术后 3～ 8个月复发 ,复发率 13% ,无药物反应和并发症发生。　结论　表阿霉素早期单次膀胱腔内灌注预防浅表性膀胱癌术后复发疗效肯定、毒副反应小 ,有较高的临床价值。     

钬激光加表阿霉素单次灌注治疗浅表性膀胱癌(附22例报告)

目的研究钬激光(Ho:YAG)加术后表阿霉素单次灌注治疗浅表性膀胱癌的临床疗效。方法自2001年1月至2002年5月,采用经尿道腔内钬激光(Ho:YAG)切除肿瘤加术后表阿霉素单次灌注治疗浅表性膀胱癌22例,其中单发肿瘤16例,多发肿瘤6例。病理分级移行细胞癌G1~G2、分期T1~T2。结果手术一次性成功,时间15~40min,术中无闭孔神经反射,无膀胱穿孔、大出血。术后灌注表阿霉素后无不良反应,1例6个月后复发,复发率4.5%,再次予钬激光处理治愈。结论钬激光加表阿霉素单次灌注治疗浅表性膀胱癌,复发率较低,是安全有效,方便易行的治疗方法。     

膀胱

浸润性膀胱癌术前选择性髂内动脉灌注化疗的近远期疗效观察；抗人膀胱癌／抗血管内皮生长因子双功能基因抗体对膀胱癌的生长抑制作用；线粒体促凋亡蛋白促进化疗药物诱导膀胱癌细胞凋亡的分子学机理研究；保留神经的全膀胱切除术对盲结肠代膀胱控尿功能的影响；尿细胞角聋白对膀胱癌术后复发的监测价值；原发浅表性膀胱癌预后影响因素分析；膀胱癌细胞Bcl-x前体mRNA剪接模式调控的研究；保留前列腺远端包膜在全膀胱切除肠代膀胱术中的应用；表阿霉素黏膜下浸润注射加单次灌注预防浅表性膀胱癌术后复发的研究；腺性膀胱炎治疗分析(附89例报告)；局麻下Sparc吊带术治疗女性压力性尿失禁(附42例报告)。     

表阿霉素单次膀胱灌注预防浅表性膀胱癌术后复发的前瞻性随机对照研究

目的　比较单次、多次表阿霉素和丝裂霉素、BCG膀胱腔内灌注预防浅表性膀胱移行细胞癌术后复发的作用。　方法　前瞻性随机对照研究 ,12 3例患者分为 4组 ,A组在术后 6h内表阿霉素 80mg单次灌注 ,B组、C组和D组分别于术后 2周内表阿霉素 4 0mg、丝裂霉素 2 0mg、BCG12 0mg多次灌注 ,观察术后复发率和无肿瘤间期及副作用发生情况。　结果　随访期 10～ 2 5个月 ,平均 18.6个月。A组复发率 18.8%、B组 14 .7%、C组 2 0 .7%、D组 17.9%。各组之间复发率及Ka plan Meier无肿瘤间期分析显示差异均无显著性意义 (P >0 .0 5 ) ,BCG组副作用明显高于其他 3组(P <0 .0 5 )。　结论　表阿霉素单次膀胱腔内灌注对预防早期、分化良好的初发浅表性膀胱移行细胞癌术后复发效果可靠 ,副作用发生率低 ,且费用低廉。     

单次腔内灌注表阿霉素预防浅表性膀胱癌术后复发的长期随访研究

目的　探讨表阿霉素单次腔内灌注预防浅表性膀胱癌术后复发的长期随访效果。　方法　浅表性膀胱癌 (Ta～ 1,G1～ 2 ) 4 7例。男 2 9例 ,女 18例。年龄 4 5～ 79岁。随机分为 3组 ,A组 (16例 )术后 6h内单次灌注表阿霉素 80mg ;B组 (15例 ) 10d内灌注 4 0mg ,以后每周 1次 ,8～ 10次后改为每月 1次 ,至术后 1年 ;C组 (16例 )用药为丝裂霉素 ,剂量及方法同B组。采用前瞻性、随机对照临床研究 ,随访 5年 ,记录患者无瘤生存期、肿瘤复发率及不良反应发生情况。　结果　随访 5年 ,4 7例中除A组 1例死于意外、1例死于其它疾病、C组 1例死于肺癌外 ,其余 4 4例均未因膀胱癌复发死亡 ,各组患者无瘤生存期无统计学差异 (F =10 .2 8,P >0 .0 5 )。 3组患者术后 5年肿瘤复发率分别为 36 %(5 / 14 )、33% (5 / 15 )、4 0 % (6 / 15 ) ,差异无显著性意义 (χ2 =0 .83,P >0 .0 5 )。 3组患者出现药物性膀胱炎者分别为 1、2、2例 ,B、C两组各有 1例尿道狭窄。总不良反应发生率分别为 14 % (2 / 14 )、5 3% (8/15 )和 4 7% (7/ 15 ) ,A组与B、C两组相比差异有非常显著性意义 (χ2 =12 .2 1,P <0 .0 1)。　结论　表阿霉素单次腔内灌注预防浅表性膀胱癌术后复发长期效果良好。     

吡喃阿霉素膀胱内灌注预防浅表性膀胱癌术后复发

目的　评价吡喃阿霉素 (THP)膀胱内灌注预防浅表性膀胱癌术后复发的疗效和安全性。　方法　对 45例浅表性膀胱癌患者行经尿道膀胱肿瘤电切术 (TURBt)或膀胱部分切除术 ,术后定期应用THP(4 0mg/ 40ml)膀胱内灌注 ,每次药物在膀胱内保留 30min。　结果　 45例患者随访 9～ 12个月 ,无肿瘤复发 44例 (97.8% ) ,复发 1例。未见有全身性药物不良反应 ,仅 2例膀胱灌药后出现短时间轻度膀胱刺激症状。　结论　THP膀胱内灌注预防浅表性膀胱癌术后复发疗效满意 ,病人耐受性好 ,副作用小     

羟基喜树碱膀胱灌注预防膀胱癌术后复发的疗效分析

目的 评价羟基喜树碱(HCPT)膀胱内灌注,预防浅表性膀胱癌术后复发的近期疗效.方法 对112例浅表性膀胱癌患者术后应用HCPT 10 mg/20 ml作膀胱内灌注,每周1次,共8次,再每2周1次,共8次,最后每个月1次,共18次,持续2年.结果 随访6～36个月,术后膀胱肿瘤复发18例,复发率16.1%.结论 HCPT膀胱内灌注,预防浅表性膀胱癌术后复发近期效果满意.     

经尿道膀胱肿瘤电切术后膀胱黏膜下注射抗肿瘤药物防治肿瘤复发

目的　探讨预防浅表性膀胱癌经尿道膀胱肿瘤电切术 (TUR Bt)术后复发的新方法。方法　初发浅表性膀胱肿瘤TUR Bt术后膀胱黏膜下注射抗肿瘤药物 (比柔吡星 )患者 6 8例 (注射组 ) ,其中肿瘤单发 4 4例、多发 2 4例 ;以TUR Bt术后膀胱内灌注化疗药物的 74例患者作为对照 (灌注组 ) ,其中肿瘤单发 4 9例、多发 2 5例。根据随访结果对两种方法预防肿瘤复发的疗效进行评价。结果　注射组平均随访 38个月 ,对照组平均随访 35个月。注射组随访期内有 8例复发 (11 8% ) ,灌注组随访期内有 2 2例复发 (2 9 7% ) ,两组复发率相比 ,差异有非常显著意义 (χ2 =0 0 13,P <0 0 1) ;注射组和灌注组中 ,肿瘤单发与多发之间复发率相比 ,差异无显著意义 (χ2 =0 719,P >0 0 5 )。结论浅表性膀胱癌TUR Bt术后单次黏膜下注射抗肿瘤药物 ,操作简单、安全有效、副作用少、费用低 ,是治疗膀胱浅表肿瘤的一种实用方法 ,可有效地预防膀胱肿瘤术后复发。     

二次电切加术中黏膜下注射吡柔比星治疗表浅性膀胱癌疗效分析

目的对比二次电切加术中黏膜下膀胱注射吡柔比星与单次电切术后即刻灌注吡柔比星预防浅表膀胱癌复发的疗效。方法 47例表浅性膀胱癌患者随机分为观察组、对照组。观察组25例行2次电切手术,第二次在术中给予30mg吡柔比星膀胱黏膜下注射;对照组22例单次电切术后6h内给予30mg吡柔比星膀胱灌注。出院后3、6、12个月检查1次膀胱镜,1年后半年检查1次,观察两组间肿瘤复发率差异。结果随访17～35个月（平均24个月）,观察组有4例（16.0%）肿瘤复发;对照组有7例（31.8%）肿瘤复发。所有患者未见明显全身药物不良反应。结论二次电切加术中黏膜下膀胱注射吡柔比星能显著降低膀胱癌患者术后复发率,其效果优于单次电切后即刻膀胱灌注。     

不同时期膀胱内灌注丝裂霉素C预防浅表性膀胱癌电切术后复发的比较研究

目的 对比评价不同时期膀胱内灌注丝裂霉素C对浅表性膀胱癌电切术后复发率和术后不良反应发生率的影响.方法 123例膀胱癌患者,其中移行细胞癌G1 37例,G2 73例,G3 13例.均行经尿道膀胱肿瘤电切术,随机分为2组,A组(术后即刻行膀胱内灌注化疗)63例,B组(术后7天开始膀胱内灌注化疗)60例,分别采用丝裂霉素C行膀胱内灌注,观察2组肿瘤复发情况、毒副反应.结果 随访18～36个月,A组复发12 例(19. 0% ).灌注期间,10例(15.9%)出现不良反应,B组复发22 例(36.7%).灌注期间,7例(11. 7%)出现不良反应.结论 术后即刻行膀胱内灌注丝裂霉素C能够减少浅表性膀胱癌的复发率,但不增加不良反应的发生率.     

经尿道膀胱肿瘤电切术中羟基喜树碱单次大剂量灌注与术后多次常规剂量灌注化疗预防膀胱癌复发的比较

目的：比较TURBT术中羟基喜树碱单次大剂量灌注与术后多次常规剂量灌注化疗预防膀胱癌复发的疗效与不良反应.方法：浅表性膀胱癌101例均行TURBT术.随机分为两组,第1组（49例）,手术结束时立即单次膀胱灌注羟基喜树碱30 mg;第2组（52例）,术后1周开始灌注,剂量20 mg,第周1次,8次后改为每月1次,至术后24个月.比较它们的疗效与不良反应.结果：随访36个月,第1组和第2组总复发率分别为18.4%和15.4%,两组间比较差异无统计学意义（P=0.67）;第1组和第2组总不良反应率分别为12.2%和30.8%,两组间比较差异有统计学意义（P=0.02）.结论：羟基喜树碱术中单次大剂量灌注预防浅表性膀胱癌术后复发疗效与术后多次常规剂量灌注化疗效果相当,而不良反应发生率低,费用少.     

Intravesical instillation of epirubicin in the prophylactic treatment of recurrent superficial bladder cancer

A retrospective study was performed to determine the efficacy of intravesical instillation of epirubicin in the prophylactic treatment for recurrent superficial bladder cancer when compared with no treatment controls. Seventeen patients with recurrent superficial bladder cancer received epirubicin (30 mg/40 ml in normal saline) seventeen times after transurethral resection (TUR). Historical controls consist of sixteen patients with recurrent superficial bladder cancer who received no adjuvant treatment after TUR. In the epirubicin group, 1-, 2- and 3-year recurrence free rates were 64.7%, 41.2% and 5.9%, respectively. In controls all of them recurred and 1- and 2-year recurrence free rates were 17.6% and 0%, respectively. The recurrence-free rate was significantly higher in the epirubicin group than in the controls (p < 0.05). We investigated whether intravesical instillation of epirubicin prolonged recurrence-free intervals when compared with recurrence-free intervals without adjuvant treatment after TUR in each patient. The 1- and 2-year recurrence free rates after initial TUR were 25% and 12.5%, respectively, and those with epirubicin treatment after TUR were 62.5% and 37.5%, respectively. Recurrence-free intervals were significantly prolonged by intravesical instillation of epirubicin as compared with those without adjuvant treatment in each patient. This study demonstrated the efficacy of intravesical instillation of epirubicin in the prophylactic treatment for superficial recurrent bladder cancer.     

表柔比星与吉西他滨膀胱灌注化疗对浅表性膀胱尿路上皮癌术后复发及安全性的影响

目的比较表柔比星与吉西他滨膀胱灌注化疗对浅表性膀胱尿路上皮癌术后复发及安全性的影响。方法遴选本院2014年3月至2017年3月收治并接受TURBT治疗的300例浅表性膀胱尿路上皮癌患者作为研究对象,根据术后灌注化疗药物选择随机分为表柔比星组和吉西他滨组各150例,并对患者进行为期2年的随访,观察两组患者术后化疗复发情况及化疗期间不良反应。结果表柔比星组患者术后6、12、24个月的复发例数分别为3、10、14例,总复发率为18.0%;吉西他滨组患者术后6、12、24个月的复发例数分别为3、8、13例,总复发率为16.0%,两组患者总复发率比较差异无统计学意义(χ^2=0.617,P=0.362)。表柔比星组总不良反应发生率为49.33%(53/150),吉西他滨组总不良反应发生率为26.67%(40/150),两组总不良反应发生率比较,差异有统计学意义(χ^2=5.52,P=0.023)。结论表柔比星与吉西他滨膀胱灌注化疗对预防浅表性膀胱尿路上皮癌术后复发的效果相当,但吉西他滨膀胱灌注产生的不良反应少,患者耐受性较好,值得临床推广。     

Perioperative single dose instillation of epirubicin or interferon-alpha after transurethral resection for the prophylaxis of primary superficial bladder cancer recurrence: a prospective randomized multicenter study--FinnBladder III long-term results

PURPOSE: We evaluated the long-term efficacy of a single dose of interferon or epirubicin administered immediately after transurethral resection compared with transurethral resection alone for primary superficial bladder cancer recurrence. MATERIAL AND METHODS: A total of 200 patients with primary superficial stages Ta to T1, grades 1 to 3 bladder cancer were randomized into 3 treatment groups, including transurethral resection alone, transurethral resection plus 50 milliunits interferon-alpha2b and transurethral resection plus 100 mg. epirubicin. The primary end point was time to first recurrence. RESULTS: At a median followup of 72 months we observed a sustained effect of a single epirubicin instillation compared with other treatments. To date only 46% of the patients in group 3 have experienced recurrence in contrast to 73% and 68% in groups 1 and 2, respectively (p = 0.002). At 72 months the Kaplan-Meier disease-free estimates were 24%, 31% and 51% in groups 1 to 3, respectively (p = 0.002). The Cox multivariate model revealed a more than 2-fold relative risk of recurrence in group 1 versus group 3 (p <0.001). Other significant variables predicting recurrence were grade and the number of tumors. CONCLUSIONS: A single perioperative instillation of 100 mg. epirubicin causes a significant and sustained decrease in primary superficial bladder cancer recurrence, whereas a single dose of 50 milliunits interferon-alpha2b is ineffective for prophylaxis.     

单次腔内灌注表柔比星预防浅表性膀胱癌术后复发

目的探讨临床应用柔比星单次腔内灌注预防浅表性膀胱癌术后复发的可行性。方法 了解表柔比星单次与多次灌汪预防表性膀胱癌术后复发的长期疗效,并与丝裂霉素疗效比较。将47例浅表性膀胱癌（Ta-1,G1－2）入选患者随机分为3组,A组（16例）患者术后6h内单次灌注表柔比星80mg;B组（15例）术后定期灌注柔比星40mg,至术后1年;C组（16例）用药为丝裂霉素,剂量及用法同B组。对入选病例行前瞻性、随机对照临床研究,随访患者无瘤生存间期、肿瘤复发率及不良反应发生情况。对所有患者术后密切随访满3年。结果 发现3年患者术后3年无病间期差异无显著性意义（F＝3．25,P＞0．05）。3组膀胱癌病例中术后1年复发情况分别为：A组1例（6．25％）、B组2例（13．3％）、C组2例（12．5％）,其差异无显著意义（χ^2＝0．496,P＞0．05）。3年复发情况分别为：A组5例（33．3％）,B组和C组各4例（26．7％,25．0％）,其差异亦无显著意义（χ^2＝0．290,P＞0．05）。不良反应发生情况分别为：A组2例（13．3％）、B组7例（（46．7％）、C组7例（43．8％）,A组患者不良反应发生率显著低于B、C2组（χ^2＝14．56,P＜0．01）。结论 表柔比星腔内灌注预防浅表性膀胱癌术后远期复发的作用可靠,可作为浅表性膀胱术后患者有效的临床辅助治疗措施。     

Transurethral resection and sequential chemo-immunoprophylaxis in primary T1G3 bladder cancer

OBJECTIVES: T1G3 superficial bladder cancer is considered to be at high risk for progression, and in some institutions early cystectomy is advocated. Other authors and personal experience suggest that conservative treatment, such as TURBT followed by intravesical prophylaxis, may be adequate in the majority of cases. The purpose of the present phase II study was to assess the tolerability and efficacy of sequential intravesical administration of a chemotherapeutic agent, epirubicin, followed by BCG, after TURBT. MATERIALS AND METHODS: 81 patients with primary T1G3 superficial bladder cancer, without evidence of Tis or upper tract tumor, underwent TURBT and intravesical prophylaxis with weekly epirubicin 50 mg for 8 weeks followed by weekly BCG Connaught 120 mg for 6 weeks. A control cystoscopy with bladder mapping and/or TUR of suspicious areas was performed at 15-17 weeks. Then patients were followed-up with 3-month urinary cytology and cystoscopy. RESULTS: The sequential chemo-immunoprophylaxis was generally well tolerated. After a mean follow-up of 48 months recurrent tumors were found in 19 patients (23.4%) and progressive disease in 6 cases (7.4%). Of 6 progressions, 4 patients died (5%) of the disease. CONCLUSION: Sequential chemo-immunoprophylaxis with epirubicin followed by BCG is well tolerated and seems to be efficacious in primary T1G3 bladder cancer. The recurrence progression and disease-specific mortality rates were acceptable so that this study seems to confirm previous data which show that TURBT and intravesical prophylaxis are appropriate treatment for the majority T1G3 tumors.     

Analysis of prognostic factors related to primary superficial bladder cancer tumor recurrence in prophylactic intravesical epirubicin therapy

PURPOSE: The aims of the present study were to examine the effects of intravesical instillation of epirubicin on tumor recurrence and to identify tumors that are at a high risk of recurrence. METHODS: Forty-five patients with primary superficial bladder cancer were treated with prophylactic intravesical epirubicin following transurethral resection of the bladder tumor (TUR-BT). Epirubicin (20 mg) was administered intravesically every second week for 4 months and then once a month or every 2 weeks for next 8 months. Patients were analyzed with respect to prognostic factors related to tumor recurrence. RESULTS: The overall recurrence-free rate, calculated using the Kaplan-Meier method, was 76.1 and 52.3% at 2 and 5 years after operation, respectively. These results were better than those reported for patients treated with TUR-BT alone. A univariate analysis demonstrated that high-grade, T1, sessile, large (> or = 2 cm) and multiple tumors were a significantly high risk for recurrence. A multivariate analysis performed by using the Cox proportional hazard model with stepwise selection showed that morphologic features (pedunculated or sessile) were the most prognostic factors for recurrence. This was followed by age and tumor size. The remaining four factors were not found to contribute significantly to recurrence. CONCLUSIONS: Epirubicin appears to be effective in preventing the recurrence of superficial bladder cancer. Morphologic features, patient age and size of the tumor were considered independent risk factors. The risk of recurrence for each tumor should be taken into consideration when the intravesical adjuvant therapy protocol is being selected.     

Intravesical combined chemoimmunotherapy with epirubicin and bacillus Calmette-Guérin is not indicated for superficial bladder cancer.

PURPOSE: The short-term effects of intravesical chemoimmunotherapy with epirubicin and bacillus Calmette-Guérin (BCG) administered repeatedly for prophylaxis of recurrence of superficial bladder cancer (pTa, pT1) were investigated in 24 patients aged a median of 70 years between March 1996 and February 1999, and were compared with those of BCG monotherapy in 50 patients from March 1990 to February 1999. PATIENTS AND METHODS: The patients underwent intravesical instillation of the Tokyo strain BCG with or without epirubicin after transurethral resection (TUR) of bladder cancer. For the combined treatment, at 1-2 weeks after TUR, epirubicin (40 mg) and BCG (80 mg) were istilled into the bladder by turns once a week for 12 weeks. For the group receiving only BCG, 80-mg instillations were done with the same schedule. Thereafter, the patients were followed by cystoscopy and urinary cytology every 3 months for up to 3 years after intravesical therapy. RESULTS AND CONCLUSIONS: At 2 years after treatment, the simple recurrence rate was 26.1% (6/23) in patients with chemoimmunotherapy and 32.0% (16/50) in BCG-treated patients. Adverse reactions, including increased frequency of urination, urgency and miction pain, were observed in 18 patients (85.7%) undergoing chemoimmunotherapy and 58.0% undergoing BCG monotherapy. One patient receiving chemoimmunotherapy was withdrawn from treatment because of symptoms of severe bladder irritation due to the instillation. Intravesical chemoimmunotherapy using epirubicin and BCG was finally found to be inferior in comparison with BCG monotherapy for the prophylaxis of recurrence of superficial bladder cancer.     

Early and large-dose intravesical instillation of epirubicin to prevent superficial bladder carcinoma recurrence after transurethral resection

OBJECTIVE: To prospectively compare the prevention of tumour recurrence by four intravesical adjuvant administration protocols, and thus elucidate the efficacy of early and high total dose instillations of epirubicin to prevent superficial bladder tumour recurrence after transurethral resection of bladder tumour (TURBT). PATIENTS AND METHODS: In all, 69 patients with Ta/T1 bladder cancer were randomly assigned to four intravesical administration protocols: A, delayed instillation (first instillation 7 days after TURBT) and low-dose (30 mg once every 2 weeks, six times): B, early instillation (three instillations before 7 days after TURBT) and low-dose; C, delayed and high-dose (30 mg once weekly 12 times) instillation; D, early and high-dose. The influence of the instillation protocols and tumour characteristics on the probability of recurrence-free survival was examined using Kaplan-Meier analysis and a Cox regression hazard model. RESULTS: The early-instillation and high-dose groups had relatively lower recurrence rates after 6 months (A, 30%; B, 25%; C, one of 12; and D, none) and 1 year (50%, 35%, four of nine and one of eight, respectively). Patients who received 360 mg epirubicin (C and D) had a significantly better recurrence-free survival than those receiving 180 mg (A and B; P = 0.012). Preoperative urine cytology and tumour multiplicity were significantly associated with recurrence. However, multivariate analysis of the risk of recurrence using a Cox proportional hazard model showed that urine cytology (hazard ratio 3.11, 95% confidence interval 1.08-8.94, P = 0.04) and total dose (0.32, 0.11-0.92, P = 0.03) were independent prognostic factors for recurrence. CONCLUSION: Patients who received a high-dose epirubicin instillation had a significantly lower recurrence rate but the benefit of early instillation was not confirmed, as the study group was too small.     

Delayed high-dose intravesical epirubicin therapy of superficial bladder cancer. A way to reduce the side effects and increase the efficacy--a phase 2 trial

INTRODUCTION: Intravesical epirubicin is a widely used agent for the treatment of superficial bladder cancer. A direct relationship between dose and activity has been reported: unfortunately the dose increase also increased the frequency and the intensity of treatment-related side effects. MATERIALS AND METHODS: A phase 2 trial was designed to evaluate the toxicity and the activity of a delayed (biweekly) high-dose (80 mg) epirubicin therapy of superficial bladder cancer. Thirty patients with intermediate risk superficial bladder cancer (stage mTa, G2) have been treated with transurethral resection and epirubicin intravesical therapy: the patients were given 80 mg epirubicin in 50 ml sterile saline every 2 weeks for 6 times (delayed regimen). The follow-up ranged from 3 to 26 months. Eleven of 30 (37%) patients experienced a local adverse reaction to intravesical epirubicin requiring specific medication (grade > or = 2 according to NCI-CTC v.2.0, 1999). No systemic toxicity related to the treatment was observed. RESULTS: Out of the 29 evaluable patients, 22 (76%) were free of disease after the induction course, 6 (21%) had superficial bladder cancer recurrences and 1 (3%) experienced tumor progression. CONCLUSION: A delayed (biweekly instillation) high-dose (80 mg) intravesical epirubicin regimen was acceptable in terms of side effects and showed a worthwhile therapeutical impact in patients with intermediate risk superficial bladder cancer.