Intravesical Thermo-Chemotherapy using the Combined Antineoplastic Thermotherapy Bladder Recirculation System (COMBAT BRS) for patients with high risk, superficial bladder cancer – early results.
Author(s):
Mrs Lisa Lavan
,
Mrs Lisa Lavan
Affiliations:
Mr Tomas Austin
,
Mr Tomas Austin
Affiliations:
Mrs Emma Greaves
,
Mrs Emma Greaves
Affiliations:
Mr Daniel Wilby
Mr Daniel Wilby
Affiliations:
BAUS ePoster online library. Lavan L. 06/26/17; 177330; P1-2
Mrs. Lisa Lavan
Mrs. Lisa Lavan
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Abstract
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Introduction: EUA guidelines recommend that patients with high-risk, superficial TCC of the bladder are treated with either intravesical BCG or, in highest risk tumours, radical cystectomy. However when patients fail BCG treatment (or as in recent times it is unavailable) and they are unfit for cystectomy then treatment options are limited. We set out to assess the efficacy of intravesical thermo-chemotherapy, using the COMBAT BRS device, in a group of such patients.
Method: Between June 2015 and August 2016 26 patients (mean age 74, range 53-88) with high grade, superficial bladder cancer were referred for a 6 week course of intravesical mitomycin with hyperthermia, using the COMBAT BRS. They then underwent rigid cystoscopy 6 weeks later. Of the 26 patients, 14 (54%) had failed BCG, 7 (27%) were eligible for BCG but it was not available, and 5 (19% ) were referred on specific consultant recommendation.
Results: 24 of the 26 patients completed the 6 weeks course. 2 patients discontinued treatment early due to pain. At the 6 week check cystoscopy, 20 (77.0%) were recurrence free, 3 (11.5%) patients had recurrent disease, 2 (7.7%) patients had progressive disease and one failed access (3.8%). Subsequently 3 recurrences were found, two at 6 months and one at 9 months. To date 9 patients remain recurrence free at 15 months and 4 are recurrence free at 18 months.
Conclusion: Early results from this small group suggest that thermo-chemotherapy is well tolerated and could be a promising treatment option in this sub-set of patients.
Introduction: EUA guidelines recommend that patients with high-risk, superficial TCC of the bladder are treated with either intravesical BCG or, in highest risk tumours, radical cystectomy. However when patients fail BCG treatment (or as in recent times it is unavailable) and they are unfit for cystectomy then treatment options are limited. We set out to assess the efficacy of intravesical thermo-chemotherapy, using the COMBAT BRS device, in a group of such patients.
Method: Between June 2015 and August 2016 26 patients (mean age 74, range 53-88) with high grade, superficial bladder cancer were referred for a 6 week course of intravesical mitomycin with hyperthermia, using the COMBAT BRS. They then underwent rigid cystoscopy 6 weeks later. Of the 26 patients, 14 (54%) had failed BCG, 7 (27%) were eligible for BCG but it was not available, and 5 (19% ) were referred on specific consultant recommendation.
Results: 24 of the 26 patients completed the 6 weeks course. 2 patients discontinued treatment early due to pain. At the 6 week check cystoscopy, 20 (77.0%) were recurrence free, 3 (11.5%) patients had recurrent disease, 2 (7.7%) patients had progressive disease and one failed access (3.8%). Subsequently 3 recurrences were found, two at 6 months and one at 9 months. To date 9 patients remain recurrence free at 15 months and 4 are recurrence free at 18 months.
Conclusion: Early results from this small group suggest that thermo-chemotherapy is well tolerated and could be a promising treatment option in this sub-set of patients.
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