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膀胱内注射卡介苗(BCG)治疗非肌层浸润性膀胱癌:改良方案的长期结果

Intravesical Bacillus Calmette-Guerin (BCG) Therapy for Non-muscle Invasive Bladder Cancers: Long-term Results of a Modified Schedule.

作者信息

Malik Kanuj, Raja Anand, Ravishankar Lalgudi Subramaniam, Narayanaswamy Kathiresan, Radhakrishnan Venkatraman, Sagar Tenali Gnana

机构信息

Department of Surgical Oncology, Cancer Institute (WIA), No. 38 Sardar Patel Marg, Adyar, Chennai, Tamil Nadu 600020 India.

Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India.

出版信息

Indian J Surg Oncol. 2021 Dec;12(4):796-801. doi: 10.1007/s13193-021-01439-w. Epub 2021 Sep 9.

Abstract

Intravesical BCG therapy is an integral part of management of non-muscle invasive bladder cancers. Our aim is to analyze the non-muscle invasive bladder cancer patients treated at our center with a modified schedule intravesical BCG therapy. Data from patients treated at our center from 2009 to 2017 was collected from patient records and analyzed. A 6-weekly 120-mg induction course followed by 6 monthly 120 mg has been used at our institute for NMIBC. Clinicopathological and treatment variables were collected. A total of 119 patients were treated at our center with a median follow-up period of 4.18 years with the above schedule. Nearly 96% patients were able to complete induction therapy and 79% completed the maintenance therapy. The 5-year recurrence-free survival was 83%. The recurrence and progression rates were 16.8% and 4.2% respectively. About 60% of the patients suffered from side effects of BCG with 11% having class 3 or 4 toxicity. Our regimen of monthly maintenance intravesical BCG for 6 months shows good control rates with high compliance, similar to those of other contemporary series, although with higher incidence of high-grade toxicity.

摘要

膀胱内卡介苗治疗是非肌肉浸润性膀胱癌治疗的重要组成部分。我们的目的是分析在我们中心接受改良方案膀胱内卡介苗治疗的非肌肉浸润性膀胱癌患者。收集并分析了2009年至2017年在我们中心接受治疗的患者的病历数据。我们研究所对非肌肉浸润性膀胱癌采用每6周120毫克的诱导疗程,随后每月120毫克,共6个月。收集临床病理和治疗变量。共有119名患者在我们中心接受了上述方案的治疗,中位随访期为4.18年。近96%的患者能够完成诱导治疗,79%的患者完成了维持治疗。5年无复发生存率为83%。复发率和进展率分别为16.8%和4.2%。约60%的患者出现卡介苗副作用,11%的患者出现3级或4级毒性。我们每月进行6个月的膀胱内卡介苗维持治疗方案显示出良好的控制率和高依从性,与其他当代系列相似,尽管高级别毒性的发生率较高。

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