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The effects and effectiveness of electromotive drug administration and chemohyperthermia for treating non-muscle invasive bladder cancer
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Slater, S. E., Patel, P., Viney, R., Foster, M., Porfiri, E., James, Nicholas D., Montgomery, B. and Bryan, Richard T. (2014) The effects and effectiveness of electromotive drug administration and chemohyperthermia for treating non-muscle invasive bladder cancer. The Annals of The Royal College of Surgeons of England, 96 (6). pp. 415-419. doi:10.1308/003588414X13946184901001 ISSN 0035-8843.
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Official URL: http://dx.doi.org/10.1308/003588414X13946184901001
Abstract
Introduction
Preliminary studies show that device assisted intravesical therapies appear more effective than passive diffusion intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC) in specific settings, and phase III studies are now being conducted. Consequently, we have undertaken a non-systematic review with the objective of describing the scientific basis and mechanisms of action of electromotive drug administration (EMDA) and chemohyperthermia (CHT).
Methods
PubMed, ClinicalTrials.gov and the Cochrane Library were searched to source evidence for this non-systematic review. Randomised controlled trials, systematic reviews and meta-analyses were evaluated. Publications regarding the scientific basis and mechanisms of action of EMDA and CHT were identified, as well as clinical studies to date.
Results
EMDA takes advantage of three phenomena: iontophoresis, electro-osmosis and electroporation. It has been found to reduce recurrence rates in NMIBC patients and has been proposed as an addition or alternative to bacillus Calmette–Guérin (BCG) therapy in the treatment of high risk NMIBC. CHT improves the efficacy of mitomycin C by three mechanisms: tumour cell cytotoxicity, altered tumour blood flow and localised immune responses. Fewer studies have been conducted with CHT than with EMDA but they have demonstrated utility for increasing disease-free survival, especially in patients who have previously failed BCG therapy.
Conclusions
It is anticipated that EMDA and CHT will play important roles in the management of NMIBC in the future. Techniques of delivery should be standardised, and there is a need for more randomised controlled trials to evaluate the benefits of the treatments alongside quality of life and cost-effectiveness.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Cancer Research Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | The Annals of The Royal College of Surgeons of England | ||||||
Publisher: | The Royal College of Surgeons of England | ||||||
ISSN: | 0035-8843 | ||||||
Official Date: | September 2014 | ||||||
Dates: |
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Volume: | 96 | ||||||
Number: | 6 | ||||||
Page Range: | pp. 415-419 | ||||||
DOI: | 10.1308/003588414X13946184901001 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access |
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