METHODS: 59 patients who underwent complete bladder tumour resection, who had a T1 high-grade tumour and no variant histology was observed in the pathology, and who had previously received intravesical BCG treatment were included in the study. Adjuvant treatment with intravesical CHT-MMC was applied. As a treatment protocol, induction was applied once a week for 6 weeks, followed by maintenance treatment 6 times at 4-week intervals. Each treatment session, it involved bladder wall hyperthermia with a temperature of up to 42 ℃ ± 2 and intravesical administration of 20 mg/50 ml MMC solution twice at 30-min intervals.
RESULTS: Recurrence-free survival after warm mitomycin was 58.7 and 48%, respectively, at 24 months and 44 months, and progression-free survival was 72.6 and 66.2%, respectively. In the subgroup analysis performed according to the number of tumours at diagnosis (single, 2-5, more than 5), recurrence-free survival rates were 81.8%, 48.2% and 11%, respectively, during the median follow-up period of 44 months.
CONCLUSIONS: Intravesical CHT-MMC can be considered as an alternative treatment in selected well-informed patients with non-muscle-invasive papillary urothelial carcinoma who are unresponsive to BCG or intolerant to BCG. Prospectively designed studies with larger number of patients are needed.
方法:59例接受完全膀胱肿瘤切除术的患者,谁有T1高级别肿瘤,在病理学中没有观察到变异的组织学,和以前接受过膀胱内BCG治疗的患者被纳入研究.应用膀胱内CHT-MMC辅助治疗。作为一种治疗方案,诱导每周一次,持续6周,随后以4周的间隔进行6次维持治疗。每次治疗,它涉及温度高达42℃±2的膀胱壁热疗,并以30分钟的间隔两次膀胱内给药20mg/50mlMMC溶液。
结果:热丝裂霉素后的无复发生存率分别为58.7%和48%,分别,在24个月和44个月,无进展生存率为72.6%和66.2%,分别。在根据诊断时肿瘤数量进行的亚组分析中(单个,2-5,超过5),无复发生存率为81.8%,48.2%和11%,分别,中位随访期44个月.
结论:膀胱内CHT-MMC可被视为对BCG无反应或对BCG不耐受的非肌肉浸润性乳头状尿路上皮癌患者的替代治疗。需要对更多患者进行前瞻性设计的研究。