Download Intravesical chemotherapy or immunotherapy for intermediate

Intravesical Chemotherapy or Immunotherapy for Intermediate-Risk Non-Muscle Invasive
Bladder Cancer: Does the Patient Mention a Different Quality of Life?
Introduction and Objectives: According to the guidelines, intravesical chemotherapy as well as
immunotherapy are valuable options as adjuvant treatment of intermediate-risk non-muscle invasive
bladder cancer (NMIBC). Both medications have their own well-reported toxicity profile. In this
prospective study, we investigated the patients’ tolerability during these treatment courses.
Furthermore, we compared changes in quality of life between both treatment options.
Materials and Methods: We randomised 110 patients with intermediate-risk NMIBC into two groups.
The first group received weekly instillations with mitomycin C (MMC) (40 mg/50 ml NaCl 0.9%) for 6
weeks, while the second group had full dose BCG instillations for 6 weeks. Afterwards, both groups
had their specific maintenance program. Patients completed the EORTC QLQ-BLS24 at baseline and
after each instillation.
Results: There were 63 patients who completed the study (33 in MMC group; 30 in BCG group). In
the MMC group, no changes were observed regarding urinary symptoms, intravesical treatment
options, future perspectives and abdominal bloating and flatulence. Only in the BCG group, a
statistically significant difference was observed for the last parameter: abdominal bloating and
flatulence (p>0.01). Comparing both treatment options, no statistical significant difference was
observed. However, the evolution of abdominal bloating and flatulence was worse in the BCG group
(p=0.06)
Conclusion: Intravesical instillations are well tolerated, irrespectively of the drug used. The tolerability
of the intestinal tract to BCG instillations was worse.