Urolog. pro Praxi, 2004; 3: 116-120

Intravezikální léčba povrchových nádorů močového měchýře

doc. MUDr. Marek Babjuk CSc, MUDr. Viktor Soukup
Urologická klinika 1. LF UK a VFN Praha

Keywords: superficial bladder tumors, recurrence, progression, intravesical chemotherapy, intravesical immunotherapy, BCG.

Published: December 31, 2004  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Babjuk M, Soukup V. Intravezikální léčba povrchových nádorů močového měchýře. Urol. praxi. 2004;5(3):116-120.

Cílem intravezikální léčby je eradikace Tis, respektive snížení rizika recidivy a progrese povrchového nádoru močového měchýře po transuretrální resekci. Intravezikální chemoterapie spočívá v aplikaci roztoku cytostatika, nejčastěji mitomycinu C nebo adriamycinu, do močového měchýře. Přináší snížení počtu časných recidiv, nemá však vliv na pozdní recidivy nebo na progresi onemocnění a volíme ji proto u nízce nebo středně rizikových nádorů.

Nejčastěji používanou látkou v intravezikální imunoterapii je BCG vakcína. Je nejúčinnější léčbou Tis, dosahuje prokazatelně lepších výsledků než intravezikální chemoterapie při redukci počtu recidiv a dle posledních zpráv snižuje riziko progrese onemocnění. Indikujeme ji proto hlavně u nádorů vysoce rizikových.

INTRAVESICAL TREATMENT OF SUPERFICIAL BLADDER TUMORS

The goal of intravesical therapy is treatment of Tis and prevention of recurrence and progression in superficial bladder tumors. Mitomycin C and adriamycin are the most often used agents in intravesical chemotherapy. They can reduce the early recurrence rate, but have no effect on late recurrences or risk of progression. Intravesical chemotherapy is used in low and intermediate risk tumors.

The most often used agent in intravesical immunotherapy is BCG. It is the most effective treatment modality in Tis, is more effective than intravesical chemotherapy and reduces the risk of tumor progression. BCG is the treatment of choice in high risk superficial tumors.

Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Bouffioux Ch, Denis L, Oosterlinck W, et al. Adjuvant chemotherapy of recurrent superficial transitional cell carcinoma: Results of a European organization for research on treatment of cancer randomized trial comparing intravesical instillation of thiotepa, doxorubicin and cisplatin. J Urol 1992; 148: 297-301. Go to original source... Go to PubMed...
    2. Bouffioux Ch, Kurth KH, Bono A, et al. Intravesical adjuvant chemotherapy for superficial transitional cell bladder carcinoma: Results of 2 European organization for research and treatment of cancer randomized trials with mitomycin C and doxorubicin comparing early versus delayed instillations and short-term versus long-term treatment. J Urol 1995; 153: 934-941. Go to original source... Go to PubMed...
    3. Böhle A, Jocham D, Bock PR. Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxocity. J Urol 2003; 169: 90-95. Go to original source... Go to PubMed...
    4. Brandau S, Böhle A. Activation of natural killer cells by bacillus Calmette-Guerin. Eur Urol 2001; 39: 518-524. Go to original source... Go to PubMed...
    5. Jakse G, Hall R, Bono A, et al. Intravesical BCG in patients with carcinoma in situ of the urinary bladder: long-term results of EORTC GU group phase II protocol 30861. Eur Urol 2001; 40: 144-150. Go to original source... Go to PubMed...
    6. Lamm DL, Blumenstein BA, Crissman JD, et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent Ta T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized southwest oncology group study. J Urol 2000; 163: 1124-1129. Go to original source... Go to PubMed...
    7. Lamm DL, Reichert DF, Harris SC, et al. Immunotherapy of murine transitional cell carcinoma. J Urol 1982; 128: 1104-1108. Go to original source... Go to PubMed...
    8. Lamm DL, Riggs DL, Traynelis ChL, et al. Apparent failure of current intravesical chemotherapy prophylaxis to influence the long-term course of superficial transitional cell carcinoma of the bladder. J Urol 1995; 153: 1444-1450. Go to original source... Go to PubMed...
    9. Lamm DL, van der Meijden APM, Morales A, et al. Incidence and treatment of complications of bacillus Calmete-Guerin intravesical therapy in superficial blader cancer. J Urol 1992; 147: 596-600. Go to original source... Go to PubMed...
    10. Martinez-Pineiro JA, Flores N, Isorna S, et al. Long-term follow-up of a randomized prospective trial comparing a standard 81 mg dose of intravesical bacille Calmette-Guerin with a reduced dose of 27 mg in superficial bladder cancer. Br J Urol Int 2002; 89: 671-680. Go to original source... Go to PubMed...
    11. Morales A, Eidinger D, Bruce AW. Intracavitary bacillus Calmette-Guerin in the treatment of superficial bladder tumors. J Urol 1976; 116: 180-182. Go to original source... Go to PubMed...
    12. O´Donnell MA, Krohn J, DeWolf W. Salvage intravesical therapy with interferon-alpha2b plus low dose bacillus Calmette-Guerin is effective in patients with superficial bladder cancer in whom bacillus Calmette-Guerin alone previously failed. J Urol 2001; 166: 1300-1305. Go to original source... Go to PubMed...
    13. Oosterlinck W, Kurth KH, Schröder F, et al. A prospective European organization for research and treatment of cancer genitourinary group randomized trial comparing transurethral resection followed by a single intravesical instillation of epirubicin or water in single stage Ta, T1 papillary carcinoma of the bladder. J Urol 1993; 149: 749-752. Go to original source... Go to PubMed...
    14. Oosterlinck W, Lobel B, Jakse G, et al. Guidelines on bladder cancer. Eur Urol 2002; 41: 105-112. Go to original source... Go to PubMed...
    15. Pacík D, Vít V, Turjanica M. Úskalí intravezikální imunoterapie povrchového karcinomu močového měchýře BCG vakcínou. Rozhl Chir 1997; 76: 3-5. Go to PubMed...
    16. Pawinski A, Sylvester R, Kurth KH, et al. A combined analysis of European organisation for research and treatment of cancer, and Medical research council randomized clinical trials for the prophylactic treatment of stage TaT1 bladder cancer. J Urol 1996; 156: 1934-1941. Go to original source...
    17. Shelley MD, Kynaston H, Court J, et al. A systemativ review of intravesical bacillus Calmette-Guerin plus transurethral resection versus transurethral resection alone in Ta and T1 bladder cancer. Br J Urol Int 2001; 88: 209-216. Go to original source... Go to PubMed...
    18. Solsona E, Iborra I, Ricos JV, et al. Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 1999; 161: 1120-1123. Go to original source... Go to PubMed...
    19. Sylvester RJ, van der Meijden APM, Lamm DL. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol 2002; 168: 1964-1970. Go to original source... Go to PubMed...
    20. van der Meijden APM, Sylvester R, Oosterlinck W, et al. Maintenance bacillus Calmette-Guerin for Ta T1 bladder cancer is not associated with increased toxocity: results from a European Organisation for Research and Treatment of Cancer Genito-Urinary Group phase III trial. Eur Urol 2003; 44: 429-434. Go to original source... Go to PubMed...

    Return to the content


    Urology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.