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首页> 外文期刊>Canadian Urological Association Journal >The role of single instillation chemotherapy in patients who receive subsequent bacillus Calmette-Guérin: A retrospective single centre study, and systematic review of the literature
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The role of single instillation chemotherapy in patients who receive subsequent bacillus Calmette-Guérin: A retrospective single centre study, and systematic review of the literature

机译：单次滴注化疗在接受后续卡介苗的患者中的作用：一项回顾性单中心研究，并对文献进行系统评价

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Introduction: This retrospective study was undertaken to evaluate the combined effect of immediate intravesical chemotherapy and subsequent bacillus Calmette-Guérin (BCG) therapy. Methods: The study population consisted of 207 intermediate- or high-risk patients with non-muscle invasive bladder cancer who underwent an induction course of BCG between 1993 and 2007. We introduced single immediate instillation of 50 mg epirubicin for all cases in 2004, and thus earlier cases could be considered as historical controls. The primary endpoint was recurrence-free survival (RFS). For cumulative analysis, we systematically reviewed studies indexed in databases. Including ours, the records of 856 patients from a total of 7 studies, including ours, were finally analyzed. Results: In our cohort, the 5-year RFS in patients who received the combination therapy was 66.2%, compared to 55.2% in the BCG alone group ( p = 0.149). Multivariate analysis on tumour recurrence showed that patients with the combination therapy had a hazard ratio (HR) of 0.74 ( p = 0.189). A subsequent literature review revealed that RFS rates in the combination groups were higher than those in the corresponding BCG alone groups in 4/7 studies ( p = 0.02–0.15), and lower in 1 study ( p = 0.51). We identified 5 studies which examined a HR for combination therapy, and performed a cumulative analysis. Adding a single chemo-instillation prior to BCG resulted in a significant reduction in tumour recurrence (summary HR 0.69, p = 0.010). Conclusions: Our analysis suggested that the combination of single chemo-instillation with subsequent BCG therapy exhibited an additive effect against potential tumour recurrence.
机译：简介：这项回顾性研究旨在评估即时膀胱内化疗和随后的卡介苗-卡瑞特芽孢杆菌（BCG）治疗的综合效果。方法：研究人群包括207例1993年至2007年间接受BCG诱导过程的中度或高危非肌肉浸润性膀胱癌患者。我们于2004年对所有病例进行了50 mg表柔比星的立即滴注，因此，较早的案例可以视为历史控制。主要终点是无复发生存期（RFS）。对于累积分析，我们系统地审查了数据库中索引的研究。包括我们在内，最终对包括我们在内的总共7项研究中的856名患者的记录进行了分析。结果：在我们的队列中，接受联合治疗的患者的5年RFS为66.2％，而仅BCG组为55.2％（p = 0.149）。肿瘤复发的多变量分析表明，联合治疗的患者的危险比（HR）为0.74（p = 0.189）。随后的文献综述显示，在4/7研究中，组合组的RFS率高于相应的单独BCG组（p = 0.02-0.15），在1个研究中较低（p = 0.51）。我们确定了5项研究，这些研究检查了HR的联合治疗，并进行了累积分析。在BCG之前添加单次化学滴注可显着降低肿瘤的复发率（总HR 0.69，p = 0.010）。结论：我们的分析表明，单次化学滴注与随后的卡介苗治疗相结合，对潜在的肿瘤复发具有累加作用。

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