Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Institute of Urology, Guangzhou, China.
Sci Rep. 2017 Jun 9;7(1):3172. doi: 10.1038/s41598-017-03421-5.
This systematic review and cumulative analysis aimed to explore the efficacy and safety of the combination of intravesical mitomycin C (MMC) plus bacillus Calmette-Guerin (BCG) for non-muscle-invasive bladder cancer (NMIBC) patients. A comprehensive literature search using Pubmed, Embase, Medline, Cochrane Library, CBM, CNKI and VIP databases was performed to identify studies applying intravesical MMC plus BCG therapy on NMIBC patients up to June 2016. Summarized unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the efficacy and safety of the combination therapy. A total of 25 studies containing 2749 NMIBC patients were included in this systematic review. Compared with BCG monotherapy, the combination therapy could significantly reduce the tumor recurrence rate (OR = 0.64, 95% CI: 0.44-0.94, P = 0.02) and cancer-specific mortality (OR = 0.54, 95% CI: 0.34-0.87, P = 0.01), without more toxicities (OR = 0.58, 95% CI: 0.17-1.94, P = 0.37). The combination therapy could also lead to significant lower tumor recurrence rate than MMC monotherapy (OR = 0.41, 95% CI: 0.24-0.69, P = 0.0009). Our study indicates that the combination of MMC plus BCG instillation is an effective and safe adjuvant treatment for NMIBC patients.
本系统评价和累积分析旨在探讨膀胱内丝裂霉素 C（MMC）联合卡介苗（BCG）治疗非肌肉浸润性膀胱癌（NMIBC）患者的疗效和安全性。使用 Pubmed、Embase、Medline、Cochrane 图书馆、CBM、CNKI 和 VIP 数据库进行全面的文献检索，以确定截至 2016 年 6 月应用膀胱内 MMC 联合 BCG 治疗 NMIBC 患者的研究。计算汇总未调整的优势比（OR）及其 95％置信区间（CI），以评估联合治疗的疗效和安全性。本系统评价共纳入 25 项研究，共 2749 例 NMIBC 患者。与 BCG 单药治疗相比，联合治疗可显著降低肿瘤复发率（OR=0.64，95％CI：0.44-0.94，P=0.02）和癌症特异性死亡率（OR=0.54，95％CI：0.34-0.87，P=0.01），且毒性无增加（OR=0.58，95％CI：0.17-1.94，P=0.37）。联合治疗也可显著降低肿瘤复发率（OR=0.41，95％CI：0.24-0.69，P=0.0009）。本研究表明，MMC 联合 BCG 膀胱内灌注是 NMIBC 患者有效且安全的辅助治疗方法。
