筋層非浸潤性膀胱癌に対する低用量BCG膀胱内注入療法の治療成績と有害事象

Abstract

We examined the efficacy and adverse effects of low-dose intravesical Bacillus Calmette-Guérin (BCG) therapy in patients with non-muscle-invasive bladder cancer. Patients who underwent intravesical BCG therapy (n＝176 ; 198 courses) at our hospital between April 2012 and December 2022 were enrolled. After assigning patients to either the low-dose or regular-dose (40 or 80 mg of BCG Tokyo 172 strain) groups, treatment efficacy and incidence of adverse events were compared. The mean number of BCG infusions in the low-dose and regular-dose groups was 6. 8 and 7. 8, respectively, although the difference was not statistically significant (P＝0.28). The median number of BCG infusions in both groups was eight, with no significant difference between them (P＝0.28). The median follow-up period after BCG therapy was 32 and 37 months in the low-dose and regular-dose groups, respectively. There were no significant differences in recurrence-free or cancer-specific survival between the groups. Although the incidence of adverse events in the low-dose group was lower than that in the regular-dose group, there was no significant differences between the groups. Multivariate analysis showed that fever and reactive arthritis were independent predictors of discontinuation of BCG therapy. Therefore, low-dose BCG therapy may be an effective treatment option for non-muscle-invasive bladder cancer.