Chemoimmune prophylaxis of superficial bladder tumors: Results after treatment of 130 patients in 4 years

Since January 1978 we performed chemoimmune prophylaxis in 130 patients with superficial transitional cell carcinoma of the bladder. After complete tumor resection and exclusion of an urinary tract infection as well as an impaired global immune competence treatment consisted of one intravenous application of 700 mg Cyclophosphamide (CTX)/m2 followed by 6 intravesical instillations of 120 mg BCG/50 ml saline together with BCG skin scarifications. In a total of 12.3% of the treated patients tumor recurrences were observed until the 18th month. These results compared favourably with the high recurrence rate in a group of 80 patients without CTX/BCG prophylaxis. In 48 patients with a history of recurrent tumors statistically significant treatment effects were noted after CTX/BCG (p less than 0.01) using the Wilcoxontest. In 10% of the cases, inflammatory tumor-like lesions developed. Side effects of the treatment were generally well tolerable. From the presented data it is concluded that chemoimmune prophylaxis effectively prevents recurrences in superficial bladder cancer.