Intravesical bacillus Calmette‐Guèrin therapy: experience with a reduced dwell‐time in patients with pronounced side‐effects

• Published in: BJU international Vol. 96; no. 9; pp. 1290 - 1293
• Main Authors: Andius, Patrik, Fehrling, Marianne, Holmäng, Sten
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.12.2005; Blackwell
• Subjects: Adjuvants, Immunologic - administration & dosage; Adjuvants, Immunologic - adverse effects; Administration, Intravesical; Aged; Antineoplastic agents; bacille Calmette‐Guèrin; BCG Vaccine - administration & dosage; BCG Vaccine - adverse effects; Biological and medical sciences; bladder neoplasm; carcinoma in situ; Carcinoma in Situ - drug therapy; Chills - chemically induced; Fever - chemically induced; Follow-Up Studies; Hematuria - chemically induced; Humans; Immunotherapy; Medical sciences; Nephrology. Urinary tract diseases; optimum dose; Pharmacology. Drug treatments; Tumors of the urinary system; Urinary Bladder Neoplasms - drug therapy; Urinary tract. Prostate gland; Urination Disorders - chemically induced; Antineoplastic agent; Nephrology; Toxicity; Bladder carcinoma; Posology; Urology; Cancerology; Immunotherapy; optimum dose; Secondary effect; Complication; Exposure time; bladder neoplasm; Human; Urinary system disease; Carcinoma in situ; Maximal dose; BCG; Malignant tumor; Urinary tract disease; Bladder cancer; Treatment; Bladder disease; Intravesical administration; bacille Calmette-Guèrin
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2005.05817.x

OBJECTIVE To report the side‐effects after a reduction in the dwell‐time in patients who had pronounced symptoms after intravesical bacillus Calmette‐Guèrin (BCG) treatment, as side‐effects such as fever, haematuria, and frequency are common and sometimes severe after BCG treatment in patients with bladder cancer. PATIENTS AND METHODS The dwell‐time was reduced to ≤ 30 min in 51 patients who had pronounced side‐effects after the preceding BCG instillation. All patients self‐reported side‐effects after each instillation in a questionnaire. RESULTS After reducing the BCG dwell‐time, fever, chills, dysuria and the overall time‐to‐recovery were significantly reduced but frequency and haematuria were not influenced. Patients with carcinoma in situ had significantly less dysuria than patients with papillary tumours. There was no difference in the treatment results between patients who had a normal dwell‐time and a reduced dwell‐time, determined at the first and second follow‐up cystoscopy. CONCLUSION Reducing the BCG dwell‐time to ≤ 30 min could be an alternative to a dose reduction in patients who experience pronounced side‐effects after BCG instillations. The long‐term outcome after reducing dwell‐time and after dose reduction has not been studied and warrants further investigation.