使用Mitomycin C膀胱熱化療對非肌肉侵犯膀胱癌-初步結果報告
溫玉清1,2*、林克勳1、林雍偉1、蕭志豪1、李良明1
臺北市立萬芳醫院 泌尿科；1臺北醫學大學 醫學院 泌尿學科
Intravesical Chemohyperthermia with Mitomycin C for Patients with Non–Muscle-invasive Bladder Cancer-Preliminary data report
Yu-Ching Wen 1,2*, Ke-Hsun Lin1, Yung-Wei Lin1, Chi-Hao Hsiao1, Liang-Ming Lee1
1 Department of Urology, Wan Fang Hospital, Taipei Medical University
2 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University
Purpose: To evaluate the safety and efficiency of external deep pelvic hyperthermia combined with intravesical mitomycin C (MMC) as an adjuvant therapy for non-muscle-invasive bladder cancer (NMIBC).
Materials and Methods: Between Jan 2016 and Oct 2017, 32 NMIBC patients were collected. Patients with recurrent bladder cancer and high risk features of recurrence and/or progression were eligible. Patients were treated with external deep pelvic hyperthermia (using a BSD-2000 device) combined with MMC 30 mg. Bladders were heated to 41oC for 1 hour during intravesical MMC treatment, weekly for 5 courses, followed by monthly MMC maintenance sessions at the rest one year. Side effects and tumor recurrence were assessed. Patient follow-up at 3-month intervals, including blood analysis, urinalysis, cytology, cystoscopy, and biopsies of suspicious areas.
Results: Ten patients were enrolled in this study. Median age was 64 years and 80% were male. Median European Organization for Research and Treatment of Cancer (EORTC) recurrence and progression scores were 6 and 8, respectively. The 12-mo recurrent free survival was 80%. No patient experienced progression during follow-up. Adverse events were all minor (grade 2 or less) and no systemic toxicity was observed. The most common adverse effects were frequency, abdominal discomfort, chemical cystitis symptoms, and abdominal skin swelling.
Conclusions: External deep pelvic hyperthermia with intravesical chemotherapy is a safe and effective treatment option in patients with NMIBC. It will hopefully substitute chemohyperthermia for high risk bladder cancer patients using BCG.