Adverse events of hyperthermic intravesical chemotherapy for non-muscle invasive bladder cancer patients. (4th July 2021)

• Record Type: Journal Article
• Authors: Thomsen, Jacob Agerbo; Nielsen Dominiak, Henning; Lindgren, Maria Skydt; Jensen, Jørgen Bjerggaard
• Is Part Of: Scandinavian journal of urology. Volume 55:Number 4(2021)
• Page Start: 281
• Page End: 286
• Publication Date: 2021-07-04
• Subjects: HIVEC -- bladder cancer -- NMIBC -- BCG unresponsive -- hyperthermia -- Mitomycin C; Urology -- Periodicals; 616.6
• DOI: 10.1080/21681805.2021.1938664
• Languages: English
• ISSNs: 2168-1805

Abstract

Abstract: Introduction: Non-muscle invasive bladder cancer (NMIBC) is one of the most frequent neoplasms in Denmark. Treatment of high-risk NMIBC usually consists of transurethral resection of bladder (TUR-B) followed by intravesical Bacillus Calmette-Guérin (BCG) instillations. Unfortunately, some patients are BCG-unresponsive and will relapse over time. Radical cystectomy is the recommended salvage treatment following BCG-failure or BCG-intolerance. However, not all patients are candidates for surgery and thus, in need of other treatment. This study investigates the adverse events of Hyperthermic Intravesical Chemotherapy (HIVEC) treatment. Methods: Twenty-three high-risk NMIBC patients, who were BCG-unresponsive or had contraindications for BCG, received HIVEC with Mitomycin C. Prior to each instillation, patients were interviewed by a nurse, using a systematic questionnaire regarding the adverse events. Patients were followed with cytology and cystoscopy every fourth month. The primary outcome was adverse event related to the HIVEC treatment. Results: In general, the adverse events were mild to moderate and often self-limiting. The most common adverse events were urinary frequency (23.6%), incontinence (19.4%) and urinary tract pain (12.2%). Conclusion: In the current study, we found that HIVEC was a well-tolerated treatment. HIVEC might be a feasible option for patients, who experienced BCG-failure or BCG-intolerance and could potentially postpone or avoid radical cystectomy.