Hurle R, Graziotti P, Ranieri A, Losa A, Micheli E, Lembo A
Divisione di Urologia, Ospedali Riuniti, Bergamo.
Arch Ital Urol Androl. 1996 Feb;68(1):13-6.
Forty-four patients affected by poorly differentiated (G3) superficial TCC invading lamina propria (stage T1) were treated with intravesical BCG. They underwent weekly instillations of 75 mg BCG for six week after trans-urethral resection (TUR) of bladder cancer. An additional induction course was given to patients who relapsed. A maintenance course with monthly instillations for twelve months followed in complete responder patients. After the first induction course, 34/44 patients (77.2%) showed complete response. In 10 patients a second induction course was necessary, with complete response in four. After one or two induction course, 38/44 patients (86.5%) showed complete response. The maintenance course was administered to 38 patients with 35/38 complete responses. After a median follow-up of 30 months, there were 29/44 (65.9%) disease free patients, 11/44 (25%) tumor recurrences and 4/44 (9%) tumor progressions. The drug has been well tolerated with few side effects. Our data suggest that intravescical BCG after TUR is effective in the treatment of high-risk superficial bladder cancer and we believe that it can be used a first approach in treating patients affected by T1G3 bladder cancer.
44例患有低分化（G3）浅表性移行细胞癌侵犯固有层（T1期）的患者接受了膀胱内卡介苗治疗。他们在膀胱癌经尿道切除（TUR）后每周接受75mg卡介苗灌注，持续六周。对复发的患者给予额外的诱导疗程。完全缓解的患者随后接受为期十二个月的每月一次灌注的维持疗程。在第一个诱导疗程后，34/44例患者（77.2%）显示完全缓解。10例患者需要第二个诱导疗程，其中4例完全缓解。在一个或两个诱导疗程后，38/44例患者（86.5%）显示完全缓解。38例患者接受了维持疗程，其中35/38例完全缓解。在中位随访30个月后，44例中有29例（65.9%）无病，11例（25%）肿瘤复发，4例（9%）肿瘤进展。该药物耐受性良好，副作用很少。我们的数据表明，TUR后膀胱内卡介苗治疗高危浅表性膀胱癌有效，我们认为它可作为治疗T1G3膀胱癌患者的首选方法。
