Intra-arterial chemotherapy combined with intravesical chemotherapy compared with intravesical BCG immunotherapy retrosp
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Intra‑arterial chemotherapy combined with intravesical chemotherapy compared with intravesical BCG immunotherapy retrospectively in high‑risk non‑muscle‑invasive bladder cancer after transurethral resection of the bladder tumor Bin Huang1 · Gaowei Huang1 · Wenji Li2 · Lingwu Chen1 · Xiaopeng Mao1 · Junxing Chen1 Received: 20 August 2020 / Accepted: 4 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To compare the efficacy and safety of intra-arterial chemotherapy (IAC) combined with intravesical chemotherapy (IVC) against intravesical BCG immunotherapy in high-risk non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of the bladder tumor (TURBT). Materials and methods 130 patients with high-risk NMIBC who had underwent TURBT were divided into two groups, of which IAC + IVC group received four courses of IAC (cisplatin and epirubicin) combined with IVC (epirubicin or pirarubicin) after surgery and BCG group received intravesical BCG immunotherapy. Recurrence rate and progression rate were assessed by Chi-square test, while recurrence-free survival and progression-free survival were calculated using the Kaplan–Meier method. Results In this study, the recurrence rate was 27.9% (12/43) in IAC + IVC group and 26.4% (14/53) in BCG group, while progression rate was 9.3% (4/43) in IAC + IVC group and 9.4% (5/53) in BCG group. Both of the recurrence and progression rate did not show a significant difference. In the Kaplan–Meier plot, no difference was found with respect to recurrence-free survival and progression-free survival. Moreover, 46.5% (20/43) patients suffered from adverse events of IAC and 83.1% (49/59) patients suffered from adverse events associated with BCG, of which 6 patients discontinued treatment due to serious adverse events of BCG. Univariate analysis suggested that only recurrent tumor could be an independent risk factor related to recurrence. Conclusions IAC combined with IVC used in high-risk NMIBC could reduce the recurrence and progression as effective as BCG instillation with lower adverse events. Keywords Intra-arterial chemotherapy · Intravesical chemotherapy · BCG · High-risk non-muscle-invasive bladder cancer
Bin Huang, Gaowei Huang and Wenji Li have contributed equally to this work. * Lingwu Chen [email protected] * Xiaopeng Mao [email protected] * Junxing Chen [email protected] 1
Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou 510080, China
Surgical Anesthesia Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou 510080, China
2
Introduction Bladder cancer is the 10th most common cancer worldwide, with an estimated 549,000 new cases and 200,000 deaths in 2018 (Bray et al. 2018), of which almost 75% of bladder cancers are non-muscle-invasive bladder cancer (NMIBC) (Burger et al. 2013). The European Organization for Research and Treatment of Cancer (EROTC)
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