Efficacy of Bladder Intravesical Chemotherapy with Three Drugs for Preventing Non-Muscle-Invasive Bladder Cancer Recurrence

Abstract

Epirubicin, gemcitabine, and pirarubicin are widely used as first-line drugs for intravesical chemotherapy to prevent tumor recurrence after transurethral bladder tumor resection for non-muscle-invasive bladder cancer (NMIBC). However, which drug is better is less discussed. A total of 335 NMIBC patients administered intravesical chemotherapy underwent transurethral bladder tumor resection (TURBT) in our hospital from October 2015 to October 2019. After TURBT, all the patients received standard intravesical chemotherapy. Through clinical data collection and telephone follow-up, the tumor recurrence and adverse reactions of all patients after bladder perfusion treatment were counted. Recurrence was defined as new tumor appearance in the bladder. Of the 335 patients who underwent intravesical chemotherapy, 109 patients received epirubicin and 114 patients and 112 patients were given gemcitabine and pirarubicin, respectively. According to the general information of the patients, the patients were divided into intermediate-risk and high-risk bladder cancer and compared separately. There was no statistical difference in clinical and pathological features between different groups ( P > 0.05 ). The recurrence rate of intermediate-risk bladder cancer patients shows no difference between three groups ( P > 0.05 ). As for the high-risk bladder cancer patients, it is found that the 1-year recurrence rate between three groups was not statistically significant ( P > 0.05 ), whereas the 2-year recurrence rate of patients given gemcitabine (9.87%) was significantly lower than that of epirubicin (25.37%) and pirarubicin (24.32%), and the difference was statistically significant ( P < 0.017 , Bonferroni adjusted P value). The Kaplan–Meier survival curves showed that the recurrence-free survival rate of patients received gemcitabine was significantly higher than that of the other two groups. Comparing the incidence of adverse reactions during the infusion of the three groups of patients, the differences were not statistically significant ( P > 0.05 ). In patients with high-risk non-muscle-invasive bladder cancer, the application of gemcitabine intravesical chemotherapy is related with a relatively lower recurrence rate but similar incidence of adverse reactions.

Singe intraoperative instillation of chemotherapy during radical cystectomy for bladder cancer: Oncological outcome and survival predictors

“…It has been demonstrated that epirubicin and pirarubicin are equally effective in preventing tumor recurrence 23,24 . Moreover, both epirubicin and pirarubicin are anthracyclines and have similar pharmacological effects 25 . In our study, we found that instillation was also not a risk factor for either DFS or CSS.…”

“… 23 , 24 Moreover, both epirubicin and pirarubicin are anthracyclines and have similar pharmacological effects. 25 In our study, we found that instillation was also not a risk factor for either DFS or CSS. Moreover, instillation was not statistically associated with either DFS or OS in the Kaplan–Meier analysis.…”

Clinicopathological Characteristics and Prognostic Factors of Primary Bladder Signet Ring Cell Carcinoma

“…In parallel, some recent studies demonstrated that adjuvant chemotherapy may be beneficial for PSRCC [ 29 , 30 ]. Intravesical chemotherapy has been deemed as the standard treatment option for muscle-invasive bladder cancer patients after receiving TURBT, which could prevent tumor relapse, inhibit tumor growth, and prolong patient survival [ 31 , 32 ]. We suggested that once PSRCC was considered by biopsy, the combination of advanced therapy should be taken into account.…”

Targeted hollow pollen silica nanoparticles for enhanced intravesical therapy of bladder cancer

“…BC mice were intravesically instilled with 100 μL of PBS containing THP, THP@HS, THP@HPS and THP@CHPS (equivalent to 5 mg kg −1 THP) for 30 min. 31 After clipping the intravesical instillation catheter, the catheter was unclipped and NP suspension was discharged spontaneously. At 24 h post-instillation, the mice were sacrificed, and the major organs (heart, liver, spleen, kidneys and lungs) and bladders were excised for the quantification of fluorescence intensity using a fluorescence imaging system (Tanon 5200 Multi).…”