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Bacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials

We determined the short-term and long-term efficacy of bacillus Calmette-Guerin (BCG) and chemotherapy in the treatment of patients with carcinoma in situ (CIS). A meta-analysis was performed on published results of randomized clinical trials comparing intravesical BCG to intravesical chemotherapy.... Full description

Journal Title: The Journal of urology July 2005, Vol.174(1), pp.86-91; discussion 91-2
Main Author: Sylvester, Richard J
Other Authors: Van Der Meijden, Adrian P M , Witjes, J Alfred , Kurth, Karlheinz
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0022-5347 ; PMID: 15947584 Version:1
Link: http://pubmed.gov/15947584
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title: Bacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials
format: Article
creator:
  • Sylvester, Richard J
  • Van Der Meijden, Adrian P M
  • Witjes, J Alfred
  • Kurth, Karlheinz
subjects:
  • Adjuvants, Immunologic -- Administration & Dosage
  • Antineoplastic Agents -- Administration & Dosage
  • Bcg Vaccine -- Administration & Dosage
  • Carcinoma in Situ -- Drug Therapy
  • Urinary Bladder Neoplasms -- Drug Therapy
ispartof: The Journal of urology, July 2005, Vol.174(1), pp.86-91; discussion 91-2
description: We determined the short-term and long-term efficacy of bacillus Calmette-Guerin (BCG) and chemotherapy in the treatment of patients with carcinoma in situ (CIS). A meta-analysis was performed on published results of randomized clinical trials comparing intravesical BCG to intravesical chemotherapy. Nine randomized trials including 700 patients with CIS compared BCG to either mitomycin C (MMC), epirubicin, adriamycin, or sequential MMC/adriamycin. Of 298 patients on BCG 203 (68.1%) had a complete response compared with 158 of 307 patients on chemotherapy (51.5%), a reduction of 47% in the odds of nonresponse on BCG (OR 0.53, p =0.0002). Based on a median followup of 3.6 years, 161 of 345 patients on BCG (46.7%) had no evidence of disease compared with 93 of 355 patients on chemotherapy (26.2%), a reduction of 59% in the odds of treatment failure on BCG (OR 0.41, p
language: eng
source:
identifier: ISSN: 0022-5347 ; PMID: 15947584 Version:1
fulltext: fulltext
issn:
  • 00225347
  • 0022-5347
url: Link


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titleBacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials
creatorSylvester, Richard J ; Van Der Meijden, Adrian P M ; Witjes, J Alfred ; Kurth, Karlheinz
ispartofThe Journal of urology, July 2005, Vol.174(1), pp.86-91; discussion 91-2
identifierISSN: 0022-5347 ; PMID: 15947584 Version:1
subjectAdjuvants, Immunologic -- Administration & Dosage ; Antineoplastic Agents -- Administration & Dosage ; Bcg Vaccine -- Administration & Dosage ; Carcinoma in Situ -- Drug Therapy ; Urinary Bladder Neoplasms -- Drug Therapy
descriptionWe determined the short-term and long-term efficacy of bacillus Calmette-Guerin (BCG) and chemotherapy in the treatment of patients with carcinoma in situ (CIS). A meta-analysis was performed on published results of randomized clinical trials comparing intravesical BCG to intravesical chemotherapy. Nine randomized trials including 700 patients with CIS compared BCG to either mitomycin C (MMC), epirubicin, adriamycin, or sequential MMC/adriamycin. Of 298 patients on BCG 203 (68.1%) had a complete response compared with 158 of 307 patients on chemotherapy (51.5%), a reduction of 47% in the odds of nonresponse on BCG (OR 0.53, p =0.0002). Based on a median followup of 3.6 years, 161 of 345 patients on BCG (46.7%) had no evidence of disease compared with 93 of 355 patients on chemotherapy (26.2%), a reduction of 59% in the odds of treatment failure on BCG (OR 0.41, p <0.0001). Although the long-term benefit of BCG was smaller in trials with MMC, BCG was superior to MMC in trials with maintenance BCG (OR 0.57, p =0.04). The reduction of 26% in the risk of progression on BCG (p =0.20) is consistent with the reduction of 27% (p =0.001) previously reported in a larger superficial bladder cancer meta-analysis. Intravesical BCG significantly reduces the risk of short and long-term treatment failure compared with intravesical chemotherapy. Therefore, it is considered to be the intravesical agent of choice in the treatment of CIS.
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titleBacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials
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0We determined the short-term and long-term efficacy of bacillus Calmette-Guerin (BCG) and chemotherapy in the treatment of patients with carcinoma in situ (CIS).
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2Nine randomized trials including 700 patients with CIS compared BCG to either mitomycin C (MMC), epirubicin, adriamycin, or sequential MMC/adriamycin. Of 298 patients on BCG 203 (68.1%) had a complete response compared with 158 of 307 patients on chemotherapy (51.5%), a reduction of 47% in the odds of nonresponse on BCG (OR 0.53, p =0.0002). Based on a median followup of 3.6 years, 161 of 345 patients on BCG (46.7%) had no evidence of disease compared with 93 of 355 patients on chemotherapy (26.2%), a reduction of 59% in the odds of treatment failure on BCG (OR 0.41, p <0.0001). Although the long-term benefit of BCG was smaller in trials with MMC, BCG was superior to MMC in trials with maintenance BCG (OR 0.57, p =0.04). The reduction of 26% in the risk of progression on BCG (p =0.20) is consistent with the reduction of 27% (p =0.001) previously reported in a larger superficial bladder cancer meta-analysis.
3Intravesical BCG significantly reduces the risk of short and long-term treatment failure compared with intravesical chemotherapy. Therefore, it is considered to be the intravesical agent of choice in the treatment of CIS.
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titleBacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials
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atitleBacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials
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abstractWe determined the short-term and long-term efficacy of bacillus Calmette-Guerin (BCG) and chemotherapy in the treatment of patients with carcinoma in situ (CIS).
pmid15947584
doi10.1097/01.ju.0000162059.64886.1c
eissn15273792
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date2005-07