Effect of Bacille Calmette-Guérin for Non–Muscle-Invasive Bladder Cancer After Prostate Radiotherapy

IF 1 4区医学 Q4 ONCOLOGY

Bladder Cancer Pub Date : 2024-01-22 DOI:10.3233/blc-230073

Adri M. Durant, Yeonsoo S. Lee, Lanyu Mi, Kassem Faraj, Timothy D. Lyon, Parminder Singh, Mark D. Tyson II

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引用次数: 0

Abstract

BACKGROUND:

Little is known about the impact of prior prostate radiation therapy (RT) on the Bacille Calmette-Guerin (BCG) immunotherapy response in patients with non-muscle invasive bladder cancer (NMIBC).

OBJECTIVE:

We hypothesized that the damaging radiation effects on the bladder could negatively influence BCG efficacy.

METHODS:

Men with a history of high-risk NMIBC were identified within the Surveillance, Epidemiology, and End Results–Medicare database. All patients completed adequate BCG defined as at least 5 plus 2 treatments completed within 12 months. Patients were stratified into 2 groups: with prior RT for prostate cancer and without prior RT before the diagnosis of NMIBC. The primary endpoint was a 5-year composite for progression defined as disease progression requiring systemic chemotherapy, checkpoint inhibitors, radical or partial cystectomy, or cancer-specific death.

RESULTS:

We identified 3,466 patients with NMIBC, including 145 with prior RT for prostate cancer. Five-year progression occurred in 471 patients (13.6%). Patients with prior RT were older than patients without prior RT (77.0 vs 75.0 years; P < .001). The distribution of T stage was significantly different at diagnosis between the RT and non-RT groups (RT: Ta, 44.8% ; Tis, 18.6% ; T1, 36.6% ; without RT: Ta, 40.9% ; Tis, 10.8% ; T1, 48.3% ; P = .002). No difference in the risk of total progression was observed between patients with and without prior RT (P = .67). Similarly, no difference was observed after multivariable adjustment (hazard ratio, 0.99; 95% CI, 0.61-1.58; P = .95).

CONCLUSION:

For patients with NMIBC who undergo adequate BCG treatment, prior RT for prostate cancer was not associated with worse 5-year progression-free survival.

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卡介苗治疗前列腺放疗后非肌层浸润性膀胱癌的效果

摘要背景：人们对既往前列腺放射治疗（RT）对非肌浸润性膀胱癌（NMIBC）患者的卡介苗（BCG）免疫疗法反应的影响知之甚少。目的：我们假设，对膀胱的破坏性放射效应可能会对BCG疗效产生负面影响。所有患者都完成了适当的卡介苗治疗，即在 12 个月内完成至少 5 次加 2 次治疗。患者被分为两组：曾接受过前列腺癌RT治疗的患者和确诊NMIBC前未接受过RT治疗的患者。主要终点是5年综合进展，即需要全身化疗、检查点抑制剂、根治性或部分膀胱切除术的疾病进展或癌症特异性死亡。结果：我们发现了3466名NMIBC患者，包括145名曾因前列腺癌接受过RT治疗的患者。471名患者（13.6%）的病情在5年内出现进展。曾接受过 RT 治疗的患者比未接受过 RT 治疗的患者年龄更大（77.0 岁 vs 75.0 岁；P < .001）。RT 组和非 RT 组在诊断时的 T 分期分布有明显差异（RT 组：Ta，44.8%；Tis，18.6%；T1，36.6%；非 RT 组：Ta，40.9%；Tis，18.6%；T1，36.6%）：Ta，40.9%；Tis，10.8%；T1，48.3%；P = .002）。既往接受过 RT 治疗和未接受过 RT 治疗的患者的总病程进展风险没有差异（P = .67）。同样，经多变量调整后也未观察到差异（危险比，0.99；95% CI，0.61-1.58；P = .95）。

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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来源期刊

Bladder Cancer Medicine-Urology

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.