Is thermochemotherapy with the Synergo system a viable treatment option in patients with recurrent non-muscle-invasive bladder cancer?

Details

Serval ID
serval:BIB_21CE2449D8C5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Is thermochemotherapy with the Synergo system a viable treatment option in patients with recurrent non-muscle-invasive bladder cancer?
Journal
International journal of urology
Author(s)
Kiss B., Schneider S., Thalmann G.N., Roth B.
ISSN
1442-2042 (Electronic)
ISSN-L
0919-8172
Publication state
Published
Issued date
02/2015
Peer-reviewed
Oui
Volume
22
Number
2
Pages
158-162
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To prospectively evaluate the outcome of combined microwave-induced bladder wall hyperthermia and intravesical mitomycin C instillation (thermochemotherapy) in patients with recurrent non-muscle-invasive bladder cancer.
Between 2003 and 2009, 21 patients (median age 70 years, range 35-95 years) with recurrent non-muscle-invasive bladder cancer (pTaG1-2 n = 9; pTaG3 n = 3; pT1 n = 9; concurrent pTis n = 8) were prospectively enrolled. Of 21 patients, 15 (71%) had received previous intravesical instillations with bacillus Calmette-Guérin, mitomycin C and/or farmorubicin. Thermochemotherapy using the Synergo system was carried out in 11 of 21 patients (52%) with curative intent, and in 10 of 21 patients (48%) as prophylaxis against recurrence.
The median number of thermochemotherapy cycles per patient was six (range 1-12). Adverse effects were frequent and severe: urinary urgency/frequency in 11 of 21 patients (52%), pain in eight of 21 patients (38%) and gross hematuria in five of 21 patients (24%). In eight of 21 patients (38%), thermochemotherapy had to be abandoned because of the severity of the adverse effects (pain in 3/8, severe bladder spasms in 2/8, allergic reaction in 2/8, urethral perforation in 1/8). Overall, six of 21 patients (29%) remained free of tumor after a median follow up of 50 months (range 1-120), six of 21 patients (29%) had to undergo cystectomy because of multifocal recurrences or cancer progression and seven of 21 patients (33%) died (2/7 of metastatic disease, 5/7 of non-cancer related causes).
Given the high rate of severe side-effects leading to treatment discontinuation, as well as the limited tumor response, thermochemotherapy should be offered only in highly selected cases of recurrent non-muscle-invasive bladder cancer.
Keywords
Administration, Intravesical, Adult, Aged, Aged, 80 and over, Antibiotics, Antineoplastic/administration & dosage, Biopsy, Female, Follow-Up Studies, Humans, Hyperthermia, Induced/methods, Instillation, Drug, Male, Middle Aged, Mitomycin/administration & dosage, Neoplasm Invasiveness, Neoplasm Recurrence, Local/pathology, Neoplasm Recurrence, Local/therapy, Neoplasm Staging, Retrospective Studies, Treatment Outcome, Urinary Bladder Neoplasms/pathology, Urinary Bladder Neoplasms/therapy, complications, intravesical instillation, mitomycin C, non-muscle-invasive bladder cancer, thermochemotherapy
Pubmed
Web of science
Create date
08/01/2021 15:35
Last modification date
09/01/2021 6:26
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