Maintenance Therapy with Intravesical Bacillus Calmette-Guerin in Patients with Intermediate- or High-risk Non-muscle-invasive Bladder Cancer
| Autor: | Raizo Yamaguchi, Shuji Isotani, Keisuke Saito, Hisamitsu Ide, Akira Horiuchi, Satoru Muto, Toshiyuki China, Masayuki Inoue, Shigeo Horie, Akiko Nakajima, Shin-ichi Hisasue |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.medical_treatment Urology Disease-Free Survival Drug Administration Schedule Adjuvants Immunologic Maintenance therapy medicine Humans Radiology Nuclear Medicine and imaging In patient Progression-free survival Adverse effect Survival rate Neoadjuvant therapy Aged Aged 80 and over Bladder cancer business.industry Hazard ratio General Medicine Middle Aged medicine.disease Surgery Administration Intravesical Treatment Outcome Urinary Bladder Neoplasms Oncology BCG Vaccine Disease Progression Female business |
| Zdroj: | Japanese Journal of Clinical Oncology. 43:305-313 |
| ISSN: | 1465-3621 0368-2811 |
| Popis: | Objective: We investigated the efficacy, safety and an optimal schedule of maintenance therapy with intravesical instillation of Bacillus-Calmette Guerin in patients with non-muscle- invasive bladder cancer. Methods: We compared the oncological outcome and adverse events of maintenance Bacillus-Calmette Guerin therapy (n ¼ 40) with control subjects (n ¼ 64) of Bacillus- Calmette Guerin induction therapy. Maintenance therapy was scheduled to be administered in 3-week cycles at 6, 12, 18, 24 and 36 months after the induction therapy. Results: There was a significant difference in the 5-year recurrence-free survival rate between the maintenance and induction groups in all patients (72.4 vs. 62.0%; P ¼ 0.019) and in patients with high recurrence risk (100.0 vs. 17.9%; P ¼ 0.009). There was a signifi- cant difference in the 5-year progression-free survival rate between the maintenance and in- duction groups in patients with high progression risk (100.0 vs. 69.3%; P ¼ 0.047). Maintenance Bacillus-Calmette Guerin instillations for a total of four times or more (recur- rence-free survival: hazard ratio: 0.2, P ¼ 0.039) or with a total dosage of .243 mg (recur- rence-free survival: hazard ratio: 0.2, P ¼ 0.041) after 6 months of induction therapy significantly improve tumor recurrence-free survival and progression-free survival. There were no significant differences between induction therapy and maintenance therapy in the fre- quency of all adverse drug reactions. Conclusions: Bacillus-Calmette Guerin maintenance therapy was effective in preventing the recurrence and progression of high-risk non-muscle-invasive bladder cancer. Maintenance Bacillus-Calmette Guerin instillations for a total of four times or more or with a total dosage of .243 mg after 6 months of induction therapy are necessary to obtain the optimal effect as maintenance therapy. |
| Databáze: | OpenAIRE |
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