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首页> 外文期刊>Anticancer Research: International Journal of Cancer Research and Treatment >Impact of intravesical chemotherapy on recurrence rate of recurrent superficial transitional cell carcinoma of the bladder: results of a meta-analysis.
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Impact of intravesical chemotherapy on recurrence rate of recurrent superficial transitional cell carcinoma of the bladder: results of a meta-analysis.

机译：膀胱内化疗对复发性膀胱浅表移行细胞癌复发率的影响：荟萃分析的结果。

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BACKGROUND: The impact of in tranvesical chemotherapy on preventing recurrence of superficial transitional cell carcinoma of the bladder is controversial. The objective of this report is to present a meta-analysis of the available clinical trial data to quantify the effect of intravesical chemotherapy on tumor recurrence following trans-urethral resection (TURB) in patients with recurrent superficial bladder cancer. METHODS: A prospective study protocol outlining a meta-analysis was developed followed by a thorough search of the existing published literature using strict eligibility criteria. Eight randomized trials were found which met protocol specifications. These studies contained data on 1,609 patients which were statistically combined using a fixed effects model (Peto). The outcome of interest was the proportion of patients with tumor recurrence at one, two and three years post-TURB. RESULTS: Combining all 8 studies using 1 year recurrence as the outcome measure yielded a Peto odds ratio (ORp) of 0.62, demonstrating a 38% reduction in one year recurrence among patients treated with intravesical chemotherapy versus TURB alone. Using 2 and 3 year recurrence as the outcome measure yielded ORp's of 0.46 and 0.35 respectively, favoring TURB + intravesical chemotherapy versus TURB alone. A statistical test for heterogeneity (Q) showed the 2 and 3 year outcome data to be heterogeneous (i.e. the studies are not measuring an effect of the same magnitude). Sensitivity analyses showed that drug type appeared to account for the observed heterogeneity with a stratified analysis demonstrating that adriamycin is less effective in reducing subsequent tumor recurrences than all other drugs studied. CONCLUSION: Intravesical chemotherapy appears to have a major impact on decreasing the chance of recurrence of recurrent superficial bladder cancer. Three year recurrence is decreased by as much as 70% when compared with TURB alone. These data are in contrast to prior analyses suggesting only modest efficacy of such treatment in this clinical setting.
机译：背景：经皮化疗对预防膀胱浅表移行细胞癌复发的影响存在争议。本报告的目的是对现有的临床试验数据进行荟萃分析，以量化膀胱内化疗对复发性浅表性膀胱癌患者经尿道切除术（TURB）后肿瘤复发的影响。方法：制定了一项前瞻性研究方案，概述了荟萃分析，然后使用严格的资格标准对现有已发表的文献进行了全面搜索。发现八项符合方案规范的随机试验。这些研究包含了1,609名患者的数据，这些数据使用固定效应模型（Peto）进行了统计合并。感兴趣的结果是TURB后1、2和3年时肿瘤复发患者的比例。结果：将全部8项研究以1年复发作为结果指标，得出的Peto比值比（ORp）为0.62，这表明与单纯TURB相比，膀胱内化疗患者的一年复发率降低了38％。使用2年和3年复发作为结果指标，ORp分别为0.46和0.35，与单独使用TURB相比，更倾向于TURB +膀胱内化疗。异质性（Q）的统计测试表明2年和3年的结局数据是异质的（即研究未测量相同幅度的影响）。敏感性分析表明，药物类型似乎可以解释观察到的异质性，分层分析表明，阿霉素比其他所有研究的药物在降低随后的肿瘤复发方面均无效。结论：膀胱内化疗似乎对减少复发性浅表性膀胱癌的复发机会具有重大影响。与仅TURB相比，三年复发率降低了多达70％。这些数据与先前的分析相反，先前的分析表明在这种临床情况下这种治疗仅适度的疗效。

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