Intravesical BCG-Therapy for Superficial Bladder Cancer: Its Effectiveness and Adverse Effects

Summary:

The aim of this investigation was to study the most significant complications of intravesical bacillus Calmette-Guérin (BCG) immunotherapy as well as the short-term effectiveness of the therapy on 174 patients with superficial transitional cell carcinoma of the bladder (Tis, Ta, or T1) treated in our hospitals. Six weekly instillations of 80 mg of BCG were given to 103 patients, six weekly and then four monthly instillations of the same dose to 55, and six weekly and then four monthly instillations of 40 mg to 16. The CR rate for Tis tumors was 79.2 % with those according to the treatment regimen being 73.5 % in the 6-week course and 88.2 % in the 6-week and then 4-month course. Bladder irritability occurred in 104 (60 %) of 174 patients, of whom 5 (3 %) had grade 3 or 4 severity according to WHO criteria. Hematuria was transiently observed in 40 (23 %) of the patients and prostatitis arose in 10 (6 %) of them. Fever over 38 °C was seen in 31 (18 %) patients, and in all but four, it was alleviated by the next day. Arthritis, skin rash, and liver dysfunction were found in some patients. As severe and troublesome complications, a contracted bladder occurred in three patients. Spinal caries and interstitial pneumonitis were respectively seen in one patient. We consider BCG immunotherapy as a very effective treatment method for superficial bladder cancer but many complications relating to BCG can occur.

Key words:

Intravesical BCG therapy - Superficial bladder cancer - Response rate - Complications