Introduction: BCG maintenance for at least one year is thebest regimen for prevention of recurrence and progression inhigh risk non muscle invasive bladder cancer (NMIBC),undergoing conservative approach. Noteworthy, a relevantnumber of patients do not complete the planned treatmentinterruption. Study aim was to analyze retrospectively thereasons of treatment. Patients and Methods: Consecutivepatients affected by T1G3 BC, undergoing BCG maintenancefor one year, according to the SWOG schedule (3 weeklyinstillations at 3, 6, 12 months) were included in this study.Connaught BCG (81 mg/50 ml) was given starting 1430 daysafter TUR. If toxicity occurred, treatment was postponed upto two weeks. No dose reduction was considered. Thepatients’ compliance with the treatment was analyzed. Results:Out of 160 patients, 148 (92.5%) completed the inductioncycle. In 10 (6.3%) more patients a recurrence was detected.In 15 (9.4%) patients induction only was planned due topersonal difficulties. In 123 patients (76.8%) maintenance forone year was planned. However, 8 patients never started and 67 (54.4%) completed only one year maintenance: 6 (4.8%)interrupted for toxicity and 9 (7,3%) for recurrence.Compliance decreased from 84.5% at 3 to 57,7% at 12months, 56 (45.6%) patients not completing one-year. Inparticular 109 patients (83.8%) completed the maintenance at3 and 88 (67.2%) at 6 months. Noteworthy, mild grade I BCGtoxicity, not requiring therapy on urologists’ opinion, wasrecorded in 91 (74%) out of 123 patients in whommaintenance was planned. Main limit was the retrospectivenature of the study. Conclusion: Maintenance interruption wasdue to moderate-severe toxicity in only 5% of the patients.The poor patient’s compliance was probably multifactorial,partially related to grade I toxicity, not taken into appropriateaccount by the urologists. A correct and periodical counsellingwith the patients undergoing BCG maintenance regimen couldameliorate the compliance to BCG.
|Numero di pagine||2|
|Stato di pubblicazione||Published - 2013|