| Optimal BCG treatment of superficial bladder cancer as defined by American trials. | |
| | |
MedLine Citation:
|
PMID: 1396941 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Immunotherapy provides an effective alternative approach to chemotherapy in the management of superficial bladder cancer. The first widely used immunotherapy, bacillus Calmette-Guérin (BCG), eradicates residual tumour bacillus Calmette-Guérin (BCG), eradicates residual tumour in one half of patients with carcinoma in situ. Unlike chemotherapy, induction of immunity against transitional cell carcinoma has the potential of protecting patients from tumours which have not yet developed. Controlled trials suggest that BCG immunotherapy reduces disease progression, decreases the need for cystectomy and prolongs survival. While the optimal BCG treatment schedule remains unknown and may in fact vary from one patient to another, data clearly suggest that a single 6-week induction course is suboptimal. In 150 randomized patients with CIS treated with 120 mg Connaught BCG, Southwest Oncology Group (SWOG) investigators found that just 3 additional weekly treatments at week 12 increased complete response from 70 to 82% (p less than 0.05). Intravesical BCG is clearly superior to oral BCG, and controlled studies have demonstrated that percutaneous administration is not necessary. While evidence suggests that BCG is the best available treatment for superficial bladder cancer and 95% of patients have no significant toxicity, serious and even fatal toxicity can occur. Sepsis can occur with intravenous absorption and often appears to result from hypersensitivity. Limited clinical and animal model experience suggests that cycloserine improves survival over treatment with isoniazid and rifampicin, but optimal treatment of BCG sepsis is isoniazid 300 mg, rifampicin 600 mg, and prednisolone 40 mg daily. |
| | |
Authors:
|
D L Lamm |
Publication Detail:
|
Type: Comparative Study; Journal Article; Review |
Journal Detail:
|
Title: European urology Volume: 21 Suppl 2 ISSN: 0302-2838 ISO Abbreviation: Eur. Urol. Publication Date: 1992 |
Date Detail:
|
Created Date: 1992-10-29 Completed Date: 1992-10-29 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 7512719 Medline TA: Eur Urol Country: SWITZERLAND |
Other Details:
|
Languages: eng Pagination: 12-6 Citation Subset: IM |
Affiliation:
|
West Virginia University, Morgantown. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Administration, Intravesical Administration, Oral BCG Vaccine / administration & dosage* Carcinoma in Situ / drug therapy, surgery, therapy* Carcinoma, Transitional Cell / drug therapy, surgery, therapy* Dose-Response Relationship, Immunologic Doxorubicin / therapeutic use Drug Administration Schedule Humans Neoplasm Recurrence, Local Prospective Studies Randomized Controlled Trials as Topic Thiotepa / therapeutic use Urinary Bladder Neoplasms / drug therapy, surgery, therapy* |
| Chemical | |
Reg. No./Substance:
|
0/BCG Vaccine; 23214-92-8/Doxorubicin; 52-24-4/Thiotepa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Diagnosis of intralobar lung sequestration by colour-coded Doppler sonography.
Next Document: Role of the immune response in BCG for bladder cancer.