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Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder
AIMS AND OBJECTIVES: The incidence of bladder malignancy is increasing worldwide and the projected rise is 28% by 2010 for both sexes (WHO). Though intravesical adjuvant therapy with BCG is superior to any other immunotherapeutic/chemotherapeutic agent in reducing tumor recurrences and disease progr...
Autores principales: | , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications
2008
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684230/ https://www.ncbi.nlm.nih.gov/pubmed/19468358 http://dx.doi.org/10.4103/0970-1591.35759 |
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author | Mohanty, N. K. Nayak, Rajiba L. Vasudeva, Pawan Arora, R. P. |
author_facet | Mohanty, N. K. Nayak, Rajiba L. Vasudeva, Pawan Arora, R. P. |
author_sort | Mohanty, N. K. |
collection | PubMed |
description | AIMS AND OBJECTIVES: The incidence of bladder malignancy is increasing worldwide and the projected rise is 28% by 2010 for both sexes (WHO). Though intravesical adjuvant therapy with BCG is superior to any other immunotherapeutic/chemotherapeutic agent in reducing tumor recurrences and disease progression, its real efficacy remains controversial as one-third of the patients will soon become BCG failure. Hence there is a need for an alternative intravesical agent for treatment of BCG failure. Our aim was to study the efficacy, tolerability and safety of intravesical Gemcitabine in managing BCG-refractory superficial bladder malignancy. MATERIALS AND METHODS: Thirty-five BCG failure patients, 26 males and nine females between 20-72 years of age were instilled with 2000 mg of Gemcitabine in 50 ml of normal saline intravesically two weeks post tumor resection, for six consecutive weeks. Mean follow-up was for 18 months with cystoscopies. RESULTS: Twenty-one patients (60%) showed no recurrences, 11 patients (31.4%) had superficial recurrences while three patients (8.6%) progressed to muscle invasiveness. Average time to first recurrence was 12 months and to disease progression was 16 months. Adverse event was low and mild. Therapy was well tolerated. CONCLUSION: Gemcitabine fulfils all requirements as an alternative agent, in treating BCG failure patients with low adverse events, is well tolerated and highly effective in reducing tumor recurrences. |
format | Text |
id | pubmed-2684230 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Medknow Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-26842302009-05-22 Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder Mohanty, N. K. Nayak, Rajiba L. Vasudeva, Pawan Arora, R. P. Indian J Urol Original Article AIMS AND OBJECTIVES: The incidence of bladder malignancy is increasing worldwide and the projected rise is 28% by 2010 for both sexes (WHO). Though intravesical adjuvant therapy with BCG is superior to any other immunotherapeutic/chemotherapeutic agent in reducing tumor recurrences and disease progression, its real efficacy remains controversial as one-third of the patients will soon become BCG failure. Hence there is a need for an alternative intravesical agent for treatment of BCG failure. Our aim was to study the efficacy, tolerability and safety of intravesical Gemcitabine in managing BCG-refractory superficial bladder malignancy. MATERIALS AND METHODS: Thirty-five BCG failure patients, 26 males and nine females between 20-72 years of age were instilled with 2000 mg of Gemcitabine in 50 ml of normal saline intravesically two weeks post tumor resection, for six consecutive weeks. Mean follow-up was for 18 months with cystoscopies. RESULTS: Twenty-one patients (60%) showed no recurrences, 11 patients (31.4%) had superficial recurrences while three patients (8.6%) progressed to muscle invasiveness. Average time to first recurrence was 12 months and to disease progression was 16 months. Adverse event was low and mild. Therapy was well tolerated. CONCLUSION: Gemcitabine fulfils all requirements as an alternative agent, in treating BCG failure patients with low adverse events, is well tolerated and highly effective in reducing tumor recurrences. Medknow Publications 2008 /pmc/articles/PMC2684230/ /pubmed/19468358 http://dx.doi.org/10.4103/0970-1591.35759 Text en © Indian Journal of Urology http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Mohanty, N. K. Nayak, Rajiba L. Vasudeva, Pawan Arora, R. P. Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
title | Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
title_full | Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
title_fullStr | Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
title_full_unstemmed | Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
title_short | Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
title_sort | management of bcg non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684230/ https://www.ncbi.nlm.nih.gov/pubmed/19468358 http://dx.doi.org/10.4103/0970-1591.35759 |
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