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首页> 外文期刊>The Journal of Urology >Salvage intravesical therapy with interferon-alpha 2b plus low dose bacillus Calmette-Guerin is effective in patients with superficial bladder cancer in whom bacillus Calmette-Guerin alone previously failed.
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Salvage intravesical therapy with interferon-alpha 2b plus low dose bacillus Calmette-Guerin is effective in patients with superficial bladder cancer in whom bacillus Calmette-Guerin alone previously failed.

机译：用干扰素-α2b加小剂量卡介苗-小剂量芽胞杆菌进行膀胱内抢救治疗对浅表膀胱癌患者有效，而先前仅​​卡介苗-芽孢杆菌失败了。

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摘要

PURPOSE: We determined whether combining low dose bacillus Calmette-Guerin (BCG) interferon-alpha 2B would be effective for patients in whom previous BCG failed. MATERIALS AND METHODS: A total of 40 patients in whom 1 (19) or more (21) previous induction courses of BCG failed received 6 to 8 weekly treatments of 1/3 dose (27 mg.) BCG plus 50 million units interferon-alpha 2B. Additional 3 week miniseries of further decreased BCG (1/10, 1/30 or 1/100) titrated to symptoms without changing the interferon-alpha 2B dose were given at 5, 11 and 17 months. In 12 patients a second induction course was given with 1/10 BCG plus 100 million units interferon-alpha 2B. There was multifocal disease in 39 patients, previous BCG had failed within 6 months in 34, disease was aggressive (stage T1, grade 3 or carcinoma in situ in 31, there had been 2 or more previous recurrences in 25 and disease history was greater than 4 years in 13. RESULTS: At a median followup of 30 months 63% and 53% of patients were disease-free at 12 and 24 months, respectively. Patients in whom 2 or more previous BCG courses had failed fared as well as those with 1 failure. Of the 18 failures 14 occurred at the initial cystoscopy evaluation. Of 22 patients initially counseled to undergo cystectomy 12 (55%) are disease-free with a functioning bladder. Combination therapy was well tolerated. CONCLUSIONS: While longer followup and larger multicenter studies are required to validate these encouraging findings, intravesical low dose BCG plus interferon-alpha 2B appears to be effective in many cases of high risk disease previously deemed BCG refractory. However, early failure while on this regimen should be aggressively pursued with more radical treatment options.
机译：目的：我们确定结合低剂量卡介苗-卡介苗（BCG）干扰素-α2B对先前的BCG失败的患者是否有效。材料与方法：总共40例先前BCG诱导疗程失败（1（19）或更多（21））的患者接受了1/3剂量（27 mg。）BCG加5千万单位干扰素-α的每周6至8疗程2B。在5、11和17个月时，给予了另外3周的小系列，进一步滴定为无症状的BCG（1 / 10、1 / 30或1/100）至症状，而无需改变干扰素-α2B剂量。在12位患者中，第二次诱导疗程使用1/10 BCG加1亿单位干扰素-α2B。 39例患者有多灶性疾病，34例先前的BCG在6个月内失败，疾病具有侵略性（T1期，3级或31例原位癌，25例曾复发2次或更多，且病史大于13年中的4年。结果：在30个月的中位随访中，分别有63％和53％的患者在12个月和24个月无病，既往经历过2次或更多次BCG疗程失败的患者以及1例失败;在18例失败中，有14例是在最初的膀胱镜检查时发生的; 22例最初接受了膀胱切除术的患者中，有12例（55％）没有疾病且膀胱功能正常;联合治疗的耐受性良好。需要进行多中心研究以验证这些令人鼓舞的发现，在许多先前认为是BCG难治的高危疾病病例中，膀胱低剂量BCG加干扰素α2B似乎是有效的。他的治疗方案应积极采取更激进的治疗方案。

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