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Low dose BCG as adjuvant therapy for superficial bladder cancer and literature review
Author(s) -
Cheng C. W.,
Ng M. T.,
Chan S. Y.,
Sun W. H.
Publication year - 2004
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2004.02941.x
Subject(s) - medicine , cystoscopy , regimen , adjuvant , surgery , toxicity , bladder cancer , cancer , disease , urinary system , bcg vaccine , adjuvant therapy , urology , chemotherapy , tuberculosis , pathology
Background: Bacillus Calmette−Guerin (BCG) at low doses has long been employed as prophylactic and therapeutic treatment for superficial cancer of the urinary bladder, aiming at reducing toxicity while maintaining efficacy. A retrospective review was reported, together with a review of the literature with respect to a low dose BCG regimen. Methods: Forty‐five consecutive patients with superficial bladder cancer (Ta or T1) with one or more of the appropriate criteria (grade above 1, stage above a, size >1 cm, multiple or recurrent), after complete transurethral resection, received 27 mg Connaught strain BCG weekly for 6 weeks. There was no maintenance therapy. Patients were evaluated with urine cytology and cystoscopy. Recurrence, progression and death were analysed. Results: With a median follow up of 14 (range 3−61) months, 24 (53%) of the 45 patients responded to one course of 6 weekly BCG without recurrence. A further group of 13 (29%) patients responded to a second course of BCG on recurrence. Disease progressed in one (2.2%) patient. Two (4.4%) patients died of an unrelated condition. There was no disease specific mortality. Side‐effects were common but well tolerated, with only two (4.4%) cases of treatment interruption. Conclusions: Low dose BCG could be an alternative option of adjuvant therapy for superficial bladder cancer with acceptable toxicity and good compliance.