Setting a new standard for topical therapy of upper-tract transitional-cell carcinoma: BCG and interferon-alpha2B.
OBJECTIVE
We report our office-based technique and results of BCG and interferon-alpha2B (BCG-IFN) for upper-tract transitional-cell carcinoma (TCC).


METHODS
Papillary lesions were ablated endoscopically after biopsy. Office flexible cystoscopy was performed, and a 0.038-inch guidewire or Glidewire was advanced into the renal pelvis. A 5F ureteral catheter was placed over the wire, and a free flow of urine was confirmed. Half-strength BCG + 50 million units of IFN was infused under low pressure for 1 hour. The ureteral catheter was removed, and patients were instructed to void 1 hour later.


RESULTS
Between 2000 and 2006, 10 patients with a median age of 72 years were treated with BCG-IFN for upper-tract TCC in 11 renal units. Follow-up ureteroscopy with or without biopsy was performed after a 6-week induction to evaluate response. Complete responders were placed on a maintenance regimen. With a median follow-up of 24 months, 8 patients (80%) demonstrated a complete response (CR) to therapy, and 2 had a partial response (decrease in tumor size, number, or both). Six patients with a CR have continued on maintenance therapy. There were no side effects or complications with the instillation therapy.


CONCLUSIONS
We describe a safe, minimally invasive, and effective office-based technique for upper-tract BCG-IFN instillation.
Katz
Mark H
MH
Department of Urology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.
Lee
Michael W
MW
Gupta
Mantu
M
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D002404:Catheterization; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011994:Recombinant Proteins; D014516:Ureteral Neoplasms / Q000188:drug therapy*
D000970:Antineoplastic Agents; D001500:BCG Vaccine; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins