The Role of a Combined Regimen With Intravesical Chemotherapy and Hyperthermia in the Management of Non-muscle-invasive Bladder Cancer: A Systematic Review

Lammers, Rianne J.M.; Witjes, J. Alfred; Inman, Brant A.; Leibovitch, Ilan; Laufer, Menachem; Nativ, Ofer; Colombo, Renzo

doi:10.1016/j.eururo.2011.04.023

Cited by 180 publications

(156 citation statements)

References 38 publications

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“…6 Even though new treatments have been reported, more results and larger studies are needed. 6,12,[14][15][16] Colombo and colleagues found that C-HT is more effective than MMC alone. 17 The 10-year disease-free survival rate for C-HT and MMC alone were 53% and 15%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…18 In a meta-analysis, the overall bladder preservation rate of 87.6% was found after C-HT. 6 In these published studies, the intravesical C-HT was performed by microwave-induced heating device (Synergo). 6,17,18 In our study, we performed intravesical C-HT with UniThermia, which is based on conductive heating.…”

Section: Discussionmentioning

confidence: 99%

“…6 In these published studies, the intravesical C-HT was performed by microwave-induced heating device (Synergo). 6,17,18 In our study, we performed intravesical C-HT with UniThermia, which is based on conductive heating. Although MMC stability and systemic absorption were comparable between conductive and microwave-induced heating, there are no studies evaluating the effectiveness of UniThermia.…”

Section: Discussionmentioning

confidence: 99%

“…5 Due to side effects and failure of BCG, new chemotherapy agents and device-assisted instillation have been tested in high-risk patients. 6 Intravesical mitomycin-C (MMC) for NMIBC has been widely studied. 4 Several studies have demonstrated the benefit of chemohyperthermia (C-HT) over intravesical chemotherapy alone.…”

Section: Introductionmentioning

confidence: 99%

“…4 Several studies have demonstrated the benefit of chemohyperthermia (C-HT) over intravesical chemotherapy alone. 6 To enhance the efficacy of MMC, two different methods for intravesical C-HT delivering have been introduced: microwave-induced heating (Synergo, Medical Enterprises, Amsterdam, Netherlands) and conductive heat (UniThermia, Elmedical, Hod-Hasharon, Israel). 7 Although studies have promising results of C-HT in high-risk NMIBC, to our knowledge, there are no comparative studies on the effectiveness of BCG and C-HT.…”

Section: Introductionmentioning

confidence: 99%

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Intravesical bacillus Calmette-Guérin versus chemohyperthermia for high-risk non-muscle-invasive bladder cancer

Ekin¹,

Akarken

Zorlu³

et al. 2015

CUAJ

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Introduction: Patients with high-risk non-muscle invasive bladder cancer (NMIBC) need adjuvant intravesical treatment after surgery. Although bacillus Calmette-Guérin (BCG) is highly effective, new adjuvant treatments to decrease recurrences and toxicity have been studies. We performed a retrospective propensity score-matched study to compare the efficacy of BCG and chemohyperthermia (C-HT). Methods: We included 1937 patients diagnosed with bladder cancer between January 2004 and January 2014. The primary efficacy endpoint was recurrence-free interval. Patients treated with C-HT were matched with patients treated with BCG using propensity score-matched analysis. Cox-regression models were used to estimate the association between intravesical treatments and the presence of recurrence and progression. Results: Of the 710 patients treated with intravesical treatments, 40 and 142 were eligible for inclusion in C-HT and BCG groups, respectively. Following case matching, there were no differences in patient or tumour characteristics between treatment groups. The 2-year recurrence-free interval in C-HT and BCG groups were 76.2% and 93.9%, respectively (p = 0.020). C-HT treatment (hazard ratio [HR] 5.42; 95% confidence interval [CI] 1.11-26.43; p = 0.036) and high-grade tumour (HR 4.60; 95% CI 1.01-20.88; p = 0.048) are associated with an elevated odds of tumour recurrence. In multivariate Cox-regression analysis, there was no significant difference between C-HT and BCG in the odds of recurrence (p = 0.054). There were no differences in progression between C-HT and BCG. Conclusion: C-HT is not as effective treatment as BCG in high-risk NMIBC patients who are BCG-naive. Although, there were no significant difference in the odds of recurrence, recurrence-free interval is significantly improved by the administration of BCG.

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