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低剂量膀胱内卡介苗:为何可能无关紧要。

Reduced Dose Intravesical Bacillus Calmette-Guérin: Why It Might Not Matter.

作者信息

Kamat Ashish M, Lobo Niyati, Lerner Seth P, Li Roger, Matulay Justin T, Palou Joan, Witjes J Alfred, Rouprêt Morgan, Smith Angela B, Chang Sam S, Shore Neal D, Steinberg Gary D, Dinney Colin P, Svatek Robert S, Lamm Donald L

机构信息

Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.

出版信息

Bladder Cancer. 2022 Jun 3;8(2):113-117. doi: 10.3233/BLC-211648. eCollection 2022.

DOI:10.3233/BLC-211648
PMID:38993360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11181808/
Abstract

When it comes to the treatment of patients with non-muscle-invasive bladder cancer (NMIBC) with intravesical bacillus Calmette-Guérin (BCG), two questions must be considered: 1) what dose to give, and 2) for how long? The issue of optimal dose and duration has been the subject of several randomized trials and is especially pertinent in the context of a global BCG shortage. Despite this, there appears to be uncertainty as to whether BCG dose or duration may be compromised in the event of shortage. As such, we wish to summarize the available evidence as an aid to the practicing urologist.

摘要

在使用膀胱内卡介苗(BCG)治疗非肌肉浸润性膀胱癌(NMIBC)患者时,必须考虑两个问题:1)给予何种剂量,以及2)持续多长时间?最佳剂量和疗程的问题一直是多项随机试验的主题,在全球卡介苗短缺的背景下尤为相关。尽管如此,在短缺情况下卡介苗剂量或疗程是否可以折衷仍存在不确定性。因此,我们希望总结现有证据,以帮助执业泌尿科医生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fff6/11181808/06bd79c07466/blc-8-blc211648-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fff6/11181808/06bd79c07466/blc-8-blc211648-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fff6/11181808/06bd79c07466/blc-8-blc211648-g001.jpg

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本文引用的文献

1
Reduced-dose bacillus Calmette-Guérin (BCG) in an era of BCG shortage: real-world experience from a tertiary cancer centre.在卡介苗短缺的时代使用低剂量卡介苗:一家三级癌症中心的真实世界经验。
BJU Int. 2022 Sep;130(3):323-330. doi: 10.1111/bju.15661. Epub 2021 Dec 13.
2
The Who, What, When, Where, and Why of Bacillus Calmette-Guérin-unresponsive Bladder Cancer.卡介苗无应答性膀胱癌的“四问”。
Eur Urol. 2021 Apr;79(4):437-439. doi: 10.1016/j.eururo.2021.01.001. Epub 2021 Jan 14.
3
Bacillus Calmette-Guérin Retains Clinically Relevant Viability for up to 72 Hours After Reconstitution: Potential Implications for Clinical Practice in Times of Shortage.
卡介苗复溶后长达 72 小时仍保持临床相关活力:短缺时期对临床实践的潜在影响。
Eur Urol Oncol. 2021 Oct;4(5):826-828. doi: 10.1016/j.euo.2020.03.004. Epub 2020 May 29.
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Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette-Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance.EORTC-GU 癌症组维持卡介苗治疗中高危 Ta、T1 膀胱乳头状癌的随机研究最终结果:三分之一剂量与全剂量和 1 年与 3 年维持治疗。
Eur Urol. 2013 Mar;63(3):462-72. doi: 10.1016/j.eururo.2012.10.039. Epub 2012 Nov 2.
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A multicentre, randomised prospective trial comparing three intravesical adjuvant therapies for intermediate-risk superficial bladder cancer: low-dose bacillus Calmette-Guerin (27 mg) versus very low-dose bacillus Calmette-Guerin (13.5 mg) versus mitomycin C.一项多中心随机前瞻性试验,比较三种用于中危浅表性膀胱癌的膀胱内辅助治疗方法:低剂量卡介苗(27毫克)对比极低剂量卡介苗(13.5毫克)对比丝裂霉素C。
Eur Urol. 2007 Nov;52(5):1398-406. doi: 10.1016/j.eururo.2007.04.062. Epub 2007 Apr 27.
6
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BJU Int. 2002 May;89(7):671-80. doi: 10.1046/j.1464-410x.2002.02722.x.