Ananthakrishnan, S (2006) Comparative study of BCG vs BCG + Interferon Combination as Intravesical Therapy in Superficial Bladder Cancer. Masters thesis, Madras Medical College, Chennai.
|
Text
180400106ananthakrishnan.pdf Download (178kB) | Preview |
Abstract
INTRODUCTION :Superficial bladder cancer constitutes 75-80% of all bladdercarcinomas. Various combinations from low stage low grade to high stageand grade tumors occur with widely varying potential to invade andmetastasize.Initial transvesical resection can give us the correct stage and gradebased on which further adjuvant therapy is planed. Adjuvant intravesicalchemotherapy or immunotherapy has shown significant cancer free survivalwhen compared to TUR alone.Morales and associates first reported the use of BCG in the treatmentof superficial bladder cancer in1976 and since then several papers havereaffirmed the effectiveness of BCG in superficial bladder cancer.BCG which has proven to be an important agent against SuperficialTCC is not with out its own drawbacks. It has wide ranging side effectswhich limit its use as well as decrease patient compliance. The toxicity isdirectly linked to the amount of BCG that is instilled into the bladder. Henceeffort has been directed at reducing the toxicity profile of BCG either byreducing the dose of BCG and or by combining BCG with otherimmunomodulators.Hence this study has been envisaged with an idea of combining bothlow dose BCG and low dose interferon and test their efficacy, safety andtoxicity profile in the management of superficial bladder cancer.AIM :The aim of the present work is to do a prospective randomizedcomparison of 120mgs of BCG against a combination of 60mgs of BCG and6 million international units of interferon alfa 2b as intravesical therapy inthe treatment of superficial bladder cancer.MATERIALS and METHODS :Study design was a prospective randomized trial. 61 patients weretotally recruited and randomized into the study over a time frame of8 months and were subjected to the following regimen. After initial TURBT(May 03 To Dec 03) and stage and grade assessment and a time gap of at least 30 days after TURBT the patients were subjected to intravesicalBCG 120mgs (Group A ) or BCG 60mg along with 6 million internationalunits of Interferon a2b ( Group B ) with 60ml of physiological saline andinstilled into the bladder.CONCLUSION :BCG (60 mgs) + IFN alpha 2b (6 Miu) combinations is equally if not bettereffective than BCG (120 mgs) alone as intravesical therapy for superficialbladder cancer.Side effects of the combination therapy are significantly better for thecombination treatment though its cost is also higher when compared to BCGalone.Definitive role for IFN + BCG combination as a first line therapy exists.Larger multicentric trials with a bigger study population and longer followup are required to come to definitive conclusions.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | BCG ; Interferon ; Intravesical Therapy Superficial Bladder Cancer ; Comparative study. |
| Subjects: | MEDICAL > Urology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 09 Aug 2017 03:42 |
| Last Modified: | 09 Aug 2017 03:42 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2523 |
Actions (login required)
 |
View Item |
