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Intravesical bacille Calmette‐Guérin in the treatment of carcinoma in situ or high‐grade superficial bladder carcinoma after radiotherapy for bladder carcinoma
Author(s) -
Palou,
Sánchez-Martín,
Rosales,
Salvador,
Algaba,
Vicente Vicente
Publication year - 1999
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.1999.00971.x
Subject(s) - medicine , carcinoma in situ , cystectomy , bladder cancer , carcinoma , radiation therapy , urology , surgery , urinary bladder , cancer
Objective To evaluate the effectiveness and tolerance of endovesical bacille Calmette‐Guérin (BCG) after pelvic radiation therapy for bladder cancer in patients with recurrence as carcinoma in situ (CIS) and/or high‐grade superficial bladder cancer. Patients and methods In a prospective study, 13 patients were treated with weekly instillations of 81 mg BCG Connaught for 6 weeks, for CIS and/or high‐grade superficial bladder carcinoma. All had been treated previously with radical radiation therapy for bladder carcinoma. Results Five patients had no recurrences and six patients retained their bladders, within a median follow‐up of 74.5 months. Five patients progressed; two underwent radical surgery and are alive after 75 months of follow‐up, and three died from the disease (two were high‐risk surgical patients and one had metastatic disease). Another two patients died from intercurrent disease without bladder cancer. Eight patients were alive at a mean (sd, range) follow‐up of 85 (12, 65–97) months. Conclusion Intravesical BCG is useful for controlling CIS and/or high‐grade superficial bladder carcinoma in irradiated bladders and has an acceptable local tolerance; more than a third of patients were free of disease and preserved their bladders. This proportion is acceptable in patients currently scheduled for cystectomy.