The Outcome of Induction Only Versus Induction and Maintenance With A Low Dose Intravesical BCG Therapy For High-Grade NMIBC

Md Shamim Hossain, K. Ghosh, A. Perveg, Md. Enamul Hoque
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Abstract

Background: According to standard guidelines, high-risk NMIBC (Non-Muscle Invasive Bladder Cancer) is treated by TUR (Transurethral resection) followed by intravesical immunotherapy(BCG). Induction followed by maintenance is recommended for achieving maximum delay of tumor recurrence and progression. Objective: This study aimed to find the outcome of induction only vs induction and maintenance, considering recurrence and progression of the disease. Materials and Methods: This experimental study was conducted in BSMMU from June 2018 to December 2020 among the histologically proved high-risk NMIBC (Ta, T1, and/ Tis) patients. Patients were allocated in two groups. In one arm BCG induction only and another arm induction and maintenance were implemented. Patients were followed up upto 2 years period. Disease recurrence and progression along with different local and systemic adverse effects were recorded add analyzed. Results: Total 30 patients were allocated in 2 groups.14 patients in induction only arm and 16 in induction and maintenance arm. Upto 24 months follow upoverall disease recurrence was 23.3% and disease progression was found in 10 % of patients. 28.5% of the induction-only arm and 18.75% patients of induction and maintenance arm developed recurrence. Whereas 7.14% of the induction-only arm and 12.5% of other arm patients developed disease progression. Both were statically insignificant (p 0.198). Conclusion: For high-risk NMIBC inductiononly BCG therapy is not inferior to induction and maintenance therapy in terms of recurrence and progression, rather it has relatively fewer adverse effects.
仅诱导与低剂量膀胱内卡介苗诱导维持治疗高级别NMIBC的结果
背景:根据标准指南,高危NMIBC(非肌肉浸润性膀胱癌)采用经尿道切除术(TUR)加膀胱内免疫治疗(BCG)治疗。为了最大限度地延缓肿瘤复发和进展,建议先诱导后维持。目的:本研究的目的是在考虑疾病复发和进展的情况下,寻找单纯诱导与诱导维持的结果。材料和方法:本实验研究于2018年6月至2020年12月在BSMMU进行,在组织学证实的高危NMIBC (Ta, T1和/ Tis)患者中进行。患者被分为两组。仅在一只手臂进行BCG诱导,另一只手臂进行诱导和维持。随访时间长达2年。记录疾病的复发和进展情况,并分析不同的局部和全身不良反应。结果:30例患者分为两组。单纯诱导组14例,诱导和维持组16例。随访24个月,总体疾病复发率为23.3%,10%的患者出现疾病进展。仅诱导组的28.5%和诱导维持组的18.75%复发。而仅诱导组的7.14%和其他组的12.5%的患者出现疾病进展。两者均无统计学意义(p 0.198)。结论:对于高危NMIBC诱导,仅卡介苗治疗在复发和进展方面并不逊色于诱导和维持治疗,相反,其不良反应相对较少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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