Comparison of hyperthermic intravesical chemotherapy using pirarubicin and Bacillus Calmette-Guérin in the treatment of patients with high-risk non-muscle-invasive bladder carcinoma: a retrospective study.

Abstract

Purpose: To evaluate and compare the effectiveness and safety of hyperthermic intravesical chemotherapy (HIVEC) utilizing pirarubicin (THP) and Bacillus Calmette-Guérin (BCG) in the treatment of individuals diagnosed with high-risk non-muscle-invasive bladder cancer (NMIBC).

Materials and methods: This study was a retrospective study that combined a review of medical records with an outcomes management database. A total of 48 patients who received HIVEC with THP and 43 patients who received BCG treatment following transurethral resection of bladder tumors (TURBT) were found between January 2017 and December 2020. Recurrence-free survival (RFS), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were evaluated.

Results: The baseline features of the HIVEC group (n = 48) and the BCG group (n = 43) were evenly matched. The median duration of follow-up was 61.0 ± 14.5 months. RFS at 1, 2, 3, 4, and 5 years of the BCG group and the HIVEC group were (90.76%, 76.54%, 58.07%, 51.14%, 45.05% vs. 98.04%, 79.53%, 62.46%, 55.93%, 50.03%, p = 0.58). PFS at 1, 2, 3, 4, and 5 years were (97.77%, 85.85%, 81.01%, 74.26%, 67.36% vs. 100.00%, 89.57%, 83.05%, 76.68%, 73.68%, p = 0.53). OS at 1, 2, 3, 4, and 5 years were (100.00%, 100.00%, 90.64%, 88.47%, 83.43% vs. 100.00%,100.00%,97.81%, 96.08%, 90.40%, p = 0.45). The overall incidence and severity of AEs related to the therapy were comparable in both groups.

Conclusion: HIVEC with THP offered a satisfactory safety profile and similar effectiveness to BCG. Our findings suggest that it may be regarded as a viable supplementary treatment for high-risk NMIBC patients when there is a shortage of BCG.