BCG for carcinoma in situ.
Bacillus Calmette-Guérin (BCG) is the most effective intravesical therapy of carcinoma in situ of the urinary bladder. Six, weekly instillations of BCG result in a complete remission in about 70-80% of patients. The optimal dose however has still to be defined, and the value of maintenance therapy is also a matter of debate. Recurrent tumours after complete remission occur mainly in the distal ureter and prostatic urethra. In these patients, cystectomy may be required. In about 60-80% of patients, local (e.g. cystitis) and/or systemic (e.g. fever, malaise) side effects are observed. The occurrence of cystitis is associated with the number of instillations, BCG dose and a positive skin test. Systemic side effects are connected with pre-existing dysuria or bacterial cystitis and with traumatic catheterization. Severe toxicity occurs in about 5% of the patients. Prognostic parameters indicating complete remission have yet to be determined, but there is evidence that cytokines detected in the urine and immune-cell infiltration into the bladder wall revealed by immunohistochemistry, can be of value in this respect.
Jakse
G
G
Department of Urology, RWTH Aachen, FRG.
D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000628:therapy*; D004317:Doxorubicin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006801:Humans; D009364:Neoplasm Recurrence, Local; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000628:therapy*
D001500:BCG Vaccine; D004317:Doxorubicin