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Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity
CONTEXT: Bacillus Calmette-Guerin (BCG) therapy is the standard treatment for nonmuscle-invasive bladder cancer (NMIBC). However, its toxicity is a major concern. AIM: If we reduce the number of BCG doses by half and replace the second half with epirubicin, we may have a lower toxicity while maintai...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3685738/ https://www.ncbi.nlm.nih.gov/pubmed/23798868 http://dx.doi.org/10.4103/0974-7796.110008 |
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author | Ali-El-Dein, Bedeir Barakat, Tamer S. Nabeeh, Adel Ibrahiem, El-Housseiny I. |
author_facet | Ali-El-Dein, Bedeir Barakat, Tamer S. Nabeeh, Adel Ibrahiem, El-Housseiny I. |
author_sort | Ali-El-Dein, Bedeir |
collection | PubMed |
description | CONTEXT: Bacillus Calmette-Guerin (BCG) therapy is the standard treatment for nonmuscle-invasive bladder cancer (NMIBC). However, its toxicity is a major concern. AIM: If we reduce the number of BCG doses by half and replace the second half with epirubicin, we may have a lower toxicity while maintaining the same efficacy of BCG. To test this hypothesis, we conducted this study as an update of our previous report. SETTING AND DESIGN: The study included 607 patients with Ta and T1 NMIBC between January 1994 and December 2008. MATERIALS AND METHODS: After transurethral resection of bladder tumor (TURBT), the patients received weekly doses of 120 mg BCG alternating with 50 mg epirubicin for six weeks (three weekly doses of each). Maintenance was given. Recurrence, progression rates, and toxicity were assessed. End points were progression, recurrence, and cancer-specific survival. RESULTS: A total of 532 patients were eligible for evaluation (mean age: 58 years; median follow-up: 45 months). Of these, 291 (55%) were free, 157 (29.5%) showed recurrence, and 84 (15.8%) showed muscle-invasive progression. Toxicity developed in 221 patients. These were mild in the majority (167), whereas 10 developed hematuria, 30 severe cystitis, and five systemic complications. The rate of permanent therapy discontinuation was 3.8%. STATISTICAL ANALYSIS USED: SPSS package version 16 and Kaplan-Meier curves were used to evaluate survival. CONCLUSIONS: Reducing the frequency of BCG instillations by half and replacing the second half with epirubicin results in a similar efficacy and a lower toxicity compared with historical cases receiving BCG alone. However, further trials are required to support these results. |
format | Online Article Text |
id | pubmed-3685738 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-36857382013-06-24 Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity Ali-El-Dein, Bedeir Barakat, Tamer S. Nabeeh, Adel Ibrahiem, El-Housseiny I. Urol Ann Original Article CONTEXT: Bacillus Calmette-Guerin (BCG) therapy is the standard treatment for nonmuscle-invasive bladder cancer (NMIBC). However, its toxicity is a major concern. AIM: If we reduce the number of BCG doses by half and replace the second half with epirubicin, we may have a lower toxicity while maintaining the same efficacy of BCG. To test this hypothesis, we conducted this study as an update of our previous report. SETTING AND DESIGN: The study included 607 patients with Ta and T1 NMIBC between January 1994 and December 2008. MATERIALS AND METHODS: After transurethral resection of bladder tumor (TURBT), the patients received weekly doses of 120 mg BCG alternating with 50 mg epirubicin for six weeks (three weekly doses of each). Maintenance was given. Recurrence, progression rates, and toxicity were assessed. End points were progression, recurrence, and cancer-specific survival. RESULTS: A total of 532 patients were eligible for evaluation (mean age: 58 years; median follow-up: 45 months). Of these, 291 (55%) were free, 157 (29.5%) showed recurrence, and 84 (15.8%) showed muscle-invasive progression. Toxicity developed in 221 patients. These were mild in the majority (167), whereas 10 developed hematuria, 30 severe cystitis, and five systemic complications. The rate of permanent therapy discontinuation was 3.8%. STATISTICAL ANALYSIS USED: SPSS package version 16 and Kaplan-Meier curves were used to evaluate survival. CONCLUSIONS: Reducing the frequency of BCG instillations by half and replacing the second half with epirubicin results in a similar efficacy and a lower toxicity compared with historical cases receiving BCG alone. However, further trials are required to support these results. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3685738/ /pubmed/23798868 http://dx.doi.org/10.4103/0974-7796.110008 Text en Copyright: © Urology Annals http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Ali-El-Dein, Bedeir Barakat, Tamer S. Nabeeh, Adel Ibrahiem, El-Housseiny I. Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity |
title | Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity |
title_full | Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity |
title_fullStr | Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity |
title_full_unstemmed | Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity |
title_short | Weekly intravesical bacillus Calmette-Guerin (BCG) alternating with epirubicin in Ta and T1 urothelial bladder cancer: An approach to decrease BCG toxicity |
title_sort | weekly intravesical bacillus calmette-guerin (bcg) alternating with epirubicin in ta and t1 urothelial bladder cancer: an approach to decrease bcg toxicity |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3685738/ https://www.ncbi.nlm.nih.gov/pubmed/23798868 http://dx.doi.org/10.4103/0974-7796.110008 |
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