Resumen de Gemcitabine intravesical for treatm ent of high-grade superficial bladder tumors
Cristina Cuesta Grueso, F.J. Merenciano Cortina, C. Borrell García, Santiago Sánchez Aranda, Jaime E. Poquet Jornet
Introduction: The standard treatment of high-grade superficial bladder tumors Ta-T1 is transurethral resection (TUR) of the tumor followed by intravesical instillations with bacillus Calmette-Guérin (BCG). Once the failure of BCG or the patient doesn’t tolerate the treatment, intravesical gemcitabine is an option. There is consensus on the gemcitabine dose (2,000 mg) but not in the dilution volume (50 or 100 mL saline, 0.9% NaCl) and whether pH should be adjusted for intravesical administration.
Objective: Our goal is the protocolization of the appropriate dilution of gemcitabine for intravesical administration, with regard to a case of high-grade papillary urothelial carcinoma who didn’t tolerate treatment with BCG adjuvant to RTU.The scientific literature related to treatment with intravesical gemcitabine was revised.
Results: The dilution of gemcitabine at our center was established as 2,000 mg of gemcitabine in 50 mL of 0.9% SF. In our experience the lower volume of dilution of intravesical gemcitabine favours retention in the bladder cavity, contributing to the successful delivery of treatment.
Conclusion: As in other studies, non alkalinisation dilutions didn’t result in a chemical cystitis. For this and the risk of precipitation, we consider not necessary the use of alkalizing agents in this dilution
