title: Evaluating the efficacy and safety of intravesical chemotherapies for non-muscle invasive bladder cancer: a network meta-analysis.
abstract: Various intravesical therapies have been introduced into clinical practices for controlling non-muscle invasive bladder cancer (NMIBC). However, evidence with respect to the efficacy and safety of those intravesical therapies is very limited. Hence, we present a network meta-analysis in order to address this limitation in the current literature. The primary outcomes were the risk of tumor recurrence (TR), tumor progression (TP) and disease-specific mortality (DM). Secondary outcomes included the risk of fever, cystitis and haematuria. Conventional pair-wise and network meta-analysis were both performed for each endpoint. The surface under the cumulative ranking curve (SUCRA) was incorporated in our analysis for ranking the corresponding intravesical instillation interventions. In total, 23 randomized clinical trials (RCTs) were finally included in our study after irrelevant papers were screened out. Results of network meta-analysis suggested that Epirubicin (EPI) was less preferable than Bacille Calmette Guerin (BCG), BCG+EPI, BCG+ Isoniazid (INH), BCG+ Mytomicin C (MMC), Gemcitabine (GEM) and MMC with respect to TR. As suggested by the corresponding ranking probabilities and SUCRA, incorporating EPI or MMC into BCG may enhance the efficacy of BCG monotherapy.
authors: Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325005, China.|Department of Psychological Medicine, Jining Medical University, Jining, Shandong, 272067, China.|Department of Psychological Medicine, Tianjin Anding Hospital, Tianjin, 300222, China.
authors: Chuanjun
authors: C
authors: Zhuo
authors: Department of Radiotherapy, Tianjin Cancer Institute & Hospital, Tianjin, 30000, China.
authors: Xubin
authors: X
authors: Li
authors: Department of Radiotherapy, Tianjin Cancer Institute & Hospital, Tianjin, 30000, China.
authors: Hongqing
authors: H
authors: Zhuang
authors: Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, 300075, China.
authors: Shunli
authors: S
authors: Tian
authors: Intensive Care Unit, Tianjin Medical University General Hospital, Tianjin, 300075, China.
authors: Hailong
authors: H
authors: Cui
authors: Department of Psychological Medicine, Chinese PLA (People's Liberation Army) General Hospital; Chinese PLA (People's Liberation Army) Medical School, Beijing, 100853, China.
authors: Ronghuan
authors: R
authors: Jiang
authors: Department of Psychological Medicine, Jining Medical University, Jining, Shandong, 272067, China.
authors: Chuanxin
authors: C
authors: Liu
authors: Beijing Shijian Integrated Medicine Science Institute, Beijing, 100700, China.
authors: Ran
authors: R
authors: Tao
authors: Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325005, China.
authors: Xiaodong
authors: X
authors: Lin
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001500:BCG Vaccine / Q000008:administration & dosage; D001499:Bayes Theorem; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000093542:Gemcitabine
chemical_list: D001500:BCG Vaccine; D003841:Deoxycytidine; D015251:Epirubicin; D016685:Mitomycin; D007538:Isoniazid; D000093542:Gemcitabine
keywords: efficacy and safety; intravesical therapy; non-muscle invasive bladder cancer; tumor progression; tumor recurrence