Re: Long-term Experience with Radiofrequency-induced Hyperthermia Combined with Intravesical Chemotherapy for Non-muscle Invasive Bladder Cancer
Abstrakt
The authors retrospectively evaluated results for ablative or adjuvant radiofrequency-induced chemohyperthermia (RF-CHT) with mitomycin C (MMC) or epirubicin in 274 patients with non-muscle-invasive bladder cancer (NMIBC). The study cohort included 128 patients (46.7%) with primary or concomitant carcinoma in situ (CIS) and 146 with papillary Ta/T1 tumours only.
Papillary lesions were of high grade except for 23 highly recurrent low-grade tumours. The majority of patients had previously been treated with intravesical instillations (85.4% bacillus Calmette-Guérin [BCG], 50.4% MMC).
Among 234 patients with previous BCG therapy, 178 (65.0%) had BCG-refractory disease. The data for patients treated with ablative intent for residual disease are very interesting.
The complete response (CR) rate at 6 mo was 56% for CIS and 52.4% for residual papillary tumours. Even more importantly, the CR rate at 6 mo in the BCG-refractory subgroup was 54.5% for CIS patients (48/88) and 43.8% (7/16) for patients with a residual papillary tumour.
The efficacy in this subgroup was durable, as demonstrated by response rates of 79.2%, 65.5%, and 38.7% for the CIS cohort and recurrence free survival of 72.5%, 54.0%, and 31.7% for the papillary group at 1 yr, 2 yr, and 5 yr, respectively.