Ovesen H
Urologisk afdeling H., Københavns Amts Sygehus i Herlev.
Ugeskr Laeger. 1994 Jan 31;156(5):628-31, 634.
Intravesical Bacillus Calmette-Guérin (BCG) has been used in the treatment of transitional neoplasia of the bladder since 1976. The indications for BCG-treatment are: 1. Carcinoma in situ (CIS), 2. Prophylaxis and 3. Treatment of tumor(s). This paper reviews the treatment schedules, results, side effects, mode of actions and the efforts at improvement of the treatment. In conclusion, the results in CIS are satisfactory, especially in primary CIS. In prophylaxis, efficacy has been demonstrated in small randomized trials against recurrence of tumor, rate of progression and survival. Unfortunately, the characteristics of the tumor(s) treated by BCG are heterogenous (stage, concomitant CIS) and the numbers of patients are small, making it difficult to determine whether there is an effect in all patients or only a subgroup. Tumor treatment with intravesical BCG is only indicated in patients not fit to undergo transurethral resection. Treatment of CIS with BCG is well established, but the exact indications for prophylaxis and tumor treatment are not known. The optimal treatment schedule has probably not been established, and further studies are necessary in an effort to improve the efficacy.
自1976年以来，膀胱内灌注卡介苗（BCG）一直用于治疗膀胱移行性肿瘤。BCG治疗的适应证为：1. 原位癌（CIS），2. 预防，3. 肿瘤治疗。本文综述了治疗方案、结果、副作用、作用方式以及改进治疗的努力。总之，CIS的治疗结果令人满意，尤其是原发性CIS。在预防方面，小型随机试验已证明其对肿瘤复发、进展率和生存率有疗效。不幸的是，接受BCG治疗的肿瘤特征各异（分期、合并CIS），且患者数量较少，难以确定其对所有患者还是仅对亚组患者有效。膀胱内BCG肿瘤治疗仅适用于不适合行经尿道切除术的患者。BCG治疗CIS已得到充分确立，但预防和肿瘤治疗的确切适应证尚不清楚。最佳治疗方案可能尚未确定，需要进一步研究以提高疗效。
