Intravesical bacille Calmette-Guerin in the treatment of carcinoma in situor high-grade superficial bladder carcinoma after radiotherapy for bladdercarcinoma
J. Palou et al., Intravesical bacille Calmette-Guerin in the treatment of carcinoma in situor high-grade superficial bladder carcinoma after radiotherapy for bladdercarcinoma, BJU INT, 83(4), 1999, pp. 429-431
Objective To evaluate the effectiveness and tolerance of endovesical bacill
e Calmette-Guerin (BCG) after pelvic radiation therapy for bladder cancer i
n patients with recurrence as carcinoma in situ (CIS) and/or high-grade sup
erficial bladder cancer.
Patients and methods In a prospective study, 13 patients were treated with
weekly instillations of 81mg 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 bl
adders, 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 o
ne had metastatic disease). Another two patients died from intercurrent dis
ease 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 pr
eserved their bladders. This proportion is acceptable in patients currently
scheduled for cystectomy.