EXPERIENCE WITH BACILLUS CALMETTE-GUERIN IN PATIENTS WITH SUPERFICIAL BLADDER-CARCINOMA
EXPERIENCE WITH BACILLUS CALMETTE-GUERIN IN PATIENTS WITH SUPERFICIAL BLADDER-CARCINOMA
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DOI：
10.1016/s0022-5347(17)52736-6
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发表时间：
1982-01-01
影响因子：
6.6
通讯作者：
BROSMAN, SA
中科院分区：
文献类型：
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作者：
BROSMAN, SA
对49例有复发性浅表性膀胱移行细胞癌病史的患者进行了一项随机研究，以确定是否可以减少肿瘤复发的频率。Tice菌株BCG或塞替派每周滴注6次，然后每2 wk滴注1次，共3 mo。每月一次，直至复发或治疗2年。另外12名先前使用塞替派失败的患者被置于BCG方案中。BCG组没有复发;塞替派组有9例患者（40%）复发。所有接受BCG治疗的患者在每次滴注后均出现膀胱刺激症状。塞替派组7例患者（25%）发生了相同类型的过敏。11例（28%）发生严重并发症，其中4例住院治疗。另12例肉眼可见的移行细胞癌患者接受卡介苗每周滴注治疗。在这些患者中，6例在18周滴注后完全消退; 2例在治疗24周后未检测到肿瘤。2例患者在6次滴注后无肿瘤。在每周滴注卡介苗治疗的7名原位癌患者中，5名患者在治疗18周后细胞异型性完全消退。这些研究证实并扩展了其他研究;膀胱灌注BCG显然可以有效降低浅表性膀胱肿瘤患者的复发率，并可以消除某些患者的现有肿瘤。每例患者都有不同程度的膀胱刺激症状; 28%的患者发生严重的全身毒性。
A randomized study was done on 49 patients with a history of recurrent superficial transitional cell carcinoma of the bladder to determine if the frequency of tumor recurrence could be lessened. The patients were treated with 6 weekly instillations of Tice strain BCG or thiotepa, followed by instillations every 2 wk for 3 mo. and every month until a recurrence developed or the patients had been treated for 2 yr. Twelve additional patients who had previously failed on thiotepa were placed on the BCG protocol. There have been no recurrences in the BCG group; 9 patients (40%) in the thiotepa group suffered recurrences. All of the patients treated with BCG had symptoms of bladder irritability after each instillation. The same type of irritability occurred in 7 patients (25%) in the thiotepa group. Severe complications occurred in 11 patients treatd with BCG (28%), 4 of whom required hospitalization. Another 12 patients with visible transitional cell carcinoma were treated with weekly instillations of BCG. Of these patients, 6 had total resolution after 18 weekly instillations; 2 had no detectable tumor after 24 wk of therapy. Two patients were free of tumor after 6 instillations. Of 7 patients with carcinoma in situ treated with weekly instillations of BCG, 5 had complete resolution of the cellular atypia after 18 wk of therapy. These studies confirm and extend those of others; bladder instillations of BCG apparently are effective in reducing the recurrence rate in patients with superficial bladder tumor and can eliminate existing tumor in some patients. Symptoms of bladder irritability occur to a varying extent in every patient; severe systemic toxicity occurred in 28% of the patients.