To develop a novel combination therapy for high-risk nonmuscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT), namely, intra-arterial chemotherapy (IAC) plus BCG immunotherapy, and to compare the feasibility and safety of the 2 therapies.
A retrospective study was conducted on the data of 119 patients who were diagnosed with high-risk NMIBC and underwent TURBT in the past 5 years. Those who did not complete the treatment were excluded, and the remaining 98 patients were divided into 2 groups: both groups received intravesical BCG immunotherapy, while the BCG+IAC group received 4 courses of extra intra-arterial chemotherapy. Clinical and follow-up data were processed using statistical software.
The recurrence rate was 22.2% in the BCG+IAC group and 35.8% in the BCG group, whereas the progression rates were 8.9% and 24.5%, respectively. In the Kaplan-Meier plot, a statistically significant difference was observed with respect to recurrence-free survival (p = 0.025), as well as the progression-free survival of the two groups was similar (p = 0.019). A total of 22.2% of the patients with adverse effects of IAC and 79.6% of patients suffered from adverse reactions to BCG immunotherapy, and most of the adverse effects were mild and tolerable. Univariate and multivariate analysis indicated that multifocal and treatment were independent risk factors for recurrence, while the history of recurrence and treatment were independent risk factors for progression.
IAC could be a promising auxiliary treatment for BCG immunotherapy in decreasing the recurrence and progression rate of high-risk NMIBC with little additional toxicity.
Urologic oncology. 2023 Oct 20 [Epub ahead of print]
Shuhang Luo, Yukun Wu, Rui Yang, Gaowei Huang, Jiahao Lei, Jinwen Liu, Shengjie Lin, Lingwu Chen, Junxing Chen, Bin Huang
Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, P.R.China; Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R.China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R.China., Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, P.R.China., Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, P.R.China. Electronic address: ., Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, P.R.China. Electronic address: .