Djug Haris, Hasukic Sefik, Jagodic Samed, Ivanic Davor
Clinic for Urology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Department of Surgery, University Clinical Centre Tuzla, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.
Med Arch. 2023;77(6):460-464. doi: 10.5455/medarh.2023.77.460-464.
The treatment strategy for non-muscle invasive bladder cancer (NMIBC) has not changed significantly over the past 30 years. Chemotherapeutic agents (mitomycin-C, epirubicin, etc.) and BCG (Bacillus Calmette-Guerin) immunotherapy are used as adjuvant intravesical therapy.
To compare the difference between adjuvant chemotherapy and adjuvant immunotherapy in their efficacy of reducing the number of tumor recurrences.
In this prospective clinical study, which included 99 patients with NMIBC from March 2018.-March 2023., we publish the results for all risk groups of patients treated with intravesical chemotherapy Epirubicin or with BCG immunotherapy, after TURBT (Trans urethral resection of bladder tumor) within 1 year. Patients were stratified into 2 groups. The first group was treated with Epirubicin (1 dose within 24 hours of surgery, then 6 weekly instillations and 3 maintenance doses), and the second group was treated with BCG (2-3 weeks after TURBT 6 weekly instillations, and 3 maintenance doses). The monitoring period was 24 months.
In patients treated with intravesical chemotherapy, recurrence occurred in 9 patients (17.64%), and in patients treated with BCG, recurrence occurred in 7 patients (14.58%). A similar incidence of disease recurrence was observed in both groups (p=0.787).
The results of our study show a similar therapeutic response by risk groups of patients treated with chemotherapy and immunotherapy. Since BCG production will cease in the future, the task of urologists is to introduce intravesical chemotherapy into wider use and to modernize it as a safe and effective method of adjuvant treatment for non-muscle-invasive bladder cancer.
在过去30年中，非肌层浸润性膀胱癌（NMIBC）的治疗策略没有显著变化。化疗药物（丝裂霉素-C、表柔比星等）和卡介苗（BCG）免疫疗法被用作辅助膀胱内治疗。
比较辅助化疗和辅助免疫疗法在减少肿瘤复发数量方面的疗效差异。
在这项前瞻性临床研究中，纳入了2018年3月至2023年3月的99例NMIBC患者，我们公布了所有风险组患者在1年内经尿道膀胱肿瘤切除术（TURBT）后接受膀胱内表柔比星化疗或BCG免疫疗法治疗的结果。患者被分为两组。第一组接受表柔比星治疗（手术24小时内1剂，然后每周灌注6次和维持剂量3次），第二组接受BCG治疗（TURBT后2 - 3周每周灌注6次，维持剂量3次）。监测期为24个月。
接受膀胱内化疗的患者中有9例复发（17.64%），接受BCG治疗的患者中有7例复发（14.58%）。两组疾病复发率相似（p = 0.787）。
我们的研究结果表明，化疗和免疫疗法治疗的风险组患者的治疗反应相似。由于未来BCG将停止生产，泌尿外科医生的任务是更广泛地应用膀胱内化疗，并将其作为非肌层浸润性膀胱癌安全有效的辅助治疗方法进行现代化改进。
