Liu Kang, Zhu Jun, Song Yu-Xuan, Wang Xiao, Zhou Ke-Chong, Lu Yi, Liu Xiao-Qiang
Department of Urology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China.
Front Oncol. 2020 Feb 5;10:29. doi: 10.3389/fonc.2020.00029. eCollection 2020.
Non-muscle invasive bladder cancer accounts for nearly 80% of newly diagnosed bladder cancer cases, which often recur and progress. This meta-analysis was evaluated by the adverse events and recurrence rate of thermal intravesical chemotherapy vs. normal temperature intravesical chemotherapy in the treatment of non-muscle invasive bladder cancer. A systematic review and cumulative analysis of studies reporting adverse events and recurrence rate of thermal intravesical chemotherapy vs. normal temperature intravesical chemotherapy was performed through a comprehensive search of Pubmed, Embase, Cochranelibrary.com, CNKI, Wanfang Med Online database and VIP database. All analyses were performed using the Revman manager 5. Twelve studies (11 randomized controlled trials and 1 retrospective study) including 888 patients, 445 in the thermal intravesical chemotherapy group, and 443 in the normal temperature intravesical chemotherapy group, met the eligibility criteria. Patients in the thermal intravesical chemotherapy group had a lower risk of disease recurrence than those who had normal temperature intravesical chemotherapy (24 months follow-up group: RR = 0.30, 95% CI: 0.21-0.43, < 0.00001, = 0%; 36 months follow-up group: RR = 0.27, 95% CI: 0.14-0.54, = 0.0002, = 0%) while no significant difference in adverse events rate (RR = 0.89, 95% CI = 0.53-1.52; = 0.67, = 78%). When compared with normal temperature intravesical chemotherapy, thermal intravesical chemotherapy can reduce the recurrence rate without increasing incidence of adverse events in patients with non-muscle invasive bladder cancer.
非肌层浸润性膀胱癌占新诊断膀胱癌病例的近80%,且常复发和进展。本荟萃分析通过热灌注膀胱化疗与常温灌注膀胱化疗治疗非肌层浸润性膀胱癌的不良事件和复发率进行评估。通过全面检索PubMed、Embase、Cochrane library.com、中国知网、万方医学在线数据库和维普数据库,对报告热灌注膀胱化疗与常温灌注膀胱化疗不良事件和复发率的研究进行系统评价和累积分析。所有分析均使用Revman manager 5进行。12项研究(11项随机对照试验和1项回顾性研究)共888例患者,其中热灌注膀胱化疗组445例,常温灌注膀胱化疗组443例,符合纳入标准。热灌注膀胱化疗组患者疾病复发风险低于常温灌注膀胱化疗组(24个月随访组:RR = 0.30,95%CI:0.21 - 0.43,P < 0.00001,I² = 0%;36个月随访组:RR = 0.27,95%CI:0.14 - 0.54,P = 0.0002,I² = 0%),而不良事件发生率无显著差异(RR = 0.89,95%CI = 0.53 - 1.52;P = 0.67,I² = 78%)。与常温灌注膀胱化疗相比,热灌注膀胱化疗可降低非肌层浸润性膀胱癌患者的复发率,且不增加不良事件发生率。