Indian Journal of Urology
ORIGINAL ARTICLE
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

Correspondence Address:
N K Mohanty
C-II/124, Moti Bagh-I, New Delhi - 110 021
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.


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