Rigatti P, Colombo R, Montorsi F, Centemero A, Guazzoni G, Di Girolamo V, Galli L, Trabucchi E
Department of Urology, Institute San Raffaele, Milan, Italy.
Scand J Urol Nephrol. 1990;24(3):191-8. doi: 10.3109/00365599009180857.
The effectiveness of intravesical administration of bacillus Calmette-Guerin as a prophylaxis of superficial bladder cancer has been definitely demonstrated. On the other hand, therapeutic regimens, duration effects, efficacy of either maintenance cycles or repeated courses of therapy in case of failures are still controversial. We report the results achieved in 15 cases of carcinoma in situ of the bladder and in 48 cases of superficial bladder cancer (Ta-T1 stage of disease) with bacillus Calmette-Guerin immunotherapy. Our patients underwent an initial six week cycle and a following maintenance cycle with monthly administrations for one year. Median follow-up was 19 months (range 18-21 months). Patients with carcinoma in situ are now free of disease; on the contrary, patients with Ta-T1 tumors experienced 18 recurrences (28%). There was a marked decrease of recurrence rate when compared to previous local chemotherapy. We report in detail the adverse effects encountered and both histologic and ultrastructural findings observed after immunotherapy. Bacillus Calmette-Guerin therapy can influence positively the natural history of the disease but possible adverse effects should always be considered before starting the treatment.
膀胱内灌注卡介苗作为浅表性膀胱癌的预防措施，其有效性已得到明确证实。另一方面，对于治疗方案、持续时间效应、治疗失败时维持周期或重复疗程的疗效仍存在争议。我们报告了15例膀胱原位癌和48例浅表性膀胱癌（Ta-T1期疾病）患者接受卡介苗免疫治疗的结果。我们的患者接受了为期六周的初始周期治疗，随后进行为期一年、每月一次的维持周期治疗。中位随访时间为19个月（范围18 - 21个月）。原位癌患者目前无疾病；相反，Ta-T1肿瘤患者出现了18次复发（28%）。与先前的局部化疗相比，复发率显著降低。我们详细报告了免疫治疗后遇到的不良反应以及观察到的组织学和超微结构结果。卡介苗治疗可对疾病的自然病程产生积极影响，但在开始治疗前应始终考虑可能的不良反应。
