The Safety and Efficacy of Different Doses of Bacillus Calmette Guérin in Superficial Bladder Transitional Cell Carcinoma

Low-Dose Versus Standard Dose of Bacillus Calmette-Guerin in the Treatment of Nonmuscle Invasive Bladder Cancer

“…Oncological outcomes reported by Morales et al 14 and Agrawal et al 21 were shown as binary variables with a median follow-up of 21 and 36 months, respectively, and the individual patient data of these studies were not able to be obtained to estimate HR. So, the 2 studies were not included in the pooled estimates of HR.…”

“…Two studies were 3-arm trials and the 2 different doses of low-dose BCG arms were combined into a single arm by the method described before. 21,22 The 8 studies included 1260 cases in the low-dose and 1199 cases in the standard dose arms. Patient demographics in the included trials are detailed in Table 3.…”

“…3,6,7,13,14,21–23 Six studies were classified with proper randomization method, 3,6,7,21–23 and 2 studies with patients sequentially allocated were categorized as qRCTs. 13,14 Allocation concealment was not performed or unclear for all the included studies.…”

“…Although none of the studies performed blinding of participants and personnel or masked the outcome assessors, the primary outcomes, for example, tumor recurrence and progression, were not likely to be influenced; therefore, corresponding domains were grades as “low risk.” Two studies were grades as high risk of attrition bias. 13,21 The assessment of risk of bias outcome of included studies was summarized in Figure 2A, B.…”

“…Maintenance intravesical BCG instillation was performed in 3 studies, 3,6,7,21 while patients only received BCG induction treatment in the other trials. 13,14,22,23 The tumor recurrence risk and overall side effects were not significantly different between the low- and standard-dose arms when trials were divided into different subgroups (Figures 3A and 4A).…”