Intravesical bacille Calmette-Guérin in the treatment of carcinoma in situ or high-grade superficial bladder carcinoma after radiotherapy for bladder carcinoma.
OBJECTIVE
To evaluate the effectiveness and tolerance of endovesical bacille Calmette-Guérin (BCG) after pelvic radiation therapy for bladder cancer in patients with recurrence as carcinoma in situ (CIS) and/or high-grade superficial bladder cancer.


METHODS
In a prospective study, 13 patients were treated with weekly instillations of 81 mg BCG Connaught for 6 weeks. for CIS and/or high-grade superficial bladder carcinoma. All had been treated previously with radical radiation therapy for bladder carcinoma.


RESULTS
Five patients had no recurrences and six patients retained their bladders, within a median follow-up of 74.5 months. Five patients progressed; two underwent radical surgery and are alive after 75 months of follow-up, and three died from the disease (two were high-risk surgical patients and one had metastatic disease). Another two patients died from intercurrent disease without bladder cancer. Eight patients were alive at a mean (SD range) follow-up of 85 (12, 65-97) months.


CONCLUSIONS
Intravesical BCG is useful for controlling CIS and/or high-grade superficial bladder carcinoma in irradiated bladders and has an acceptable local tolerance: more than a third of patients were free of disease and preserved their bladders. This proportion is acceptable in patients currently scheduled for cystectomy.
Palou
J
J
Fundació Puigvert, Universitat Autònoma de Barcelona, Spain.
Sánchez-Martín
F M
FM
Rosales
A
A
Salvador
J
J
Algaba
F
F
Vicente
J
J
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000379:methods; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy / Q000628:therapy*
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine