Intravesical Mitomycin-C with Bladder Wall Hyperthermia in Intermediate and High-risk Non-muscle Invasive Bladder Cancers: Prospective Clinical Trial with a Singletreatment Arm

• Published in: Üroonkoloji bülteni 2020-12, Vol.19 (4), p.182-185
• Main Authors: Demirtaş, Abdullah, Tombul, Şevket Tolga, Sönmez, Gökhan, Demirleğen, Akın, Demirtaş, Türev, Tatlışen, Atila
• Format: Article
• Language: English
• Subjects: Bladder; Bladder cancer; Cancer; Catheters; Cellular biology; Chemotherapy; Fever; Hyperthermia; Pathology; Patients; Statistical analysis; Survival analysis; Urine; Urogenital system
• ISSN: 2147-2122; 2147-2270
• DOI: 10.4274/uob.galenos.2019.1314

Objective: Bacillus Calmette-Guérin (BCG) limited availability, cost, and allergic response in some patients limit its use, leading to the search for alternative agents. We aimed to present the outcomes of intermediate- and high-risk non-muscle invasive bladder cancers treated with bladder wall thermochemotherapy (BWT) system via a single-arm prospective study. Materials and Methods: Overall, 44 patients were enrolled and subjected to a treatment with mitomycin-C and BWT for 6 weeks, followed by a monthly maintenance for up to 1 year. The recurrence rate, progression rate, recurrence-free survival, progression-free survival, and side effects were evaluated. Results: In the intermediate- and high-risk groups, the median follow-up duration was 14 and 17 months; recurrence rates were 28.6% and 23.3%; progression rates were 7.1% and 23.3%; the recurrence free survival at the 24th month were 78.6% and 80.0% and the progression free survival at the 24th month were 92.6% and 76.7%, respectively. All the patients suffered from dysuria lasting for 2-3 days; five of the 442 BWT application developed allergic reactions requiring treatments with oral agents. Conclusion: BWT showed comparable recurrence and progression rates, but seemed safer than BCG when our findings were compared to those of published studies. It could be an alternative for individuals who are not suitable for BCG or in a case of BCG unavailability.