Year : 2008 | Volume
: 24 | Issue : 1 | Page : 44--47
Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder
NK Mohanty, Rajiba L Nayak, Pawan Vasudeva, RP Arora
Department of Urology, VM Medical College and Safdarjung Hospital, New Delhi, India
Aims and Objectives: The incidence of bladder malignancy is increasing worldwide and the projected rise is 28% by 2010 for both sexes (WHO). Though intravesical adjuvant therapy with BCG is superior to any other immunotherapeutic/chemotherapeutic agent in reducing tumor recurrences and disease progression, its real efficacy remains controversial as one-third of the patients will soon become BCG failure. Hence there is a need for an alternative intravesical agent for treatment of BCG failure. Our aim was to study the efficacy, tolerability and safety of intravesical Gemcitabine in managing BCG-refractory superficial bladder malignancy.
Materials and Methods: Thirty-five BCG failure patients, 26 males and nine females between 20-72 years of age were instilled with 2000 mg of Gemcitabine in 50 ml of normal saline intravesically two weeks post tumor resection, for six consecutive weeks. Mean follow-up was for 18 months with cystoscopies.
Results: Twenty-one patients (60%) showed no recurrences, 11 patients (31.4%) had superficial recurrences while three patients (8.6%) progressed to muscle invasiveness. Average time to first recurrence was 12 months and to disease progression was 16 months. Adverse event was low and mild. Therapy was well tolerated.
Conclusion: Gemcitabine fulfils all requirements as an alternative agent, in treating BCG failure patients with low adverse events, is well tolerated and highly effective in reducing tumor recurrences.
N K Mohanty
C-II/124, Moti Bagh-I, New Delhi - 110 021
|How to cite this article:|
Mohanty N K, Nayak RL, Vasudeva P, Arora R P. Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder.Indian J Urol 2008;24:44-47
|How to cite this URL:|
Mohanty N K, Nayak RL, Vasudeva P, Arora R P. Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder. Indian J Urol [serial online] 2008 [cited 2020 Oct 27 ];24:44-47
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2008;volume=24;issue=1;spage=44;epage=47;aulast=Mohanty;type=0