Retrospective evaluation of the effects of intra-arterial chemotherapy combined with intravesical BCG immunotherapy versus BCG immunotherapy in high-risk non-muscle-invasive bladder cancer after transurethral resection of the bladder tumor

Abstract Purpose To develop a novel combination therapy for high-risk non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT), namely, intra-arterial chemotherapy (IAC) plus BCG immunotherapy, and to compare the feasibility and safety of the two therapies. Materials and methods A retrospective review was conducted on the data of 134 patients who were diagnosed with high-risk NMIBC and underwent TURBT in the past five years. A total of 134 patients were initially enrolled and screened according to inclusion criteria, and the remaining 103 patients were divided into two groups according to the aspiration of patients: both groups received intravesical BCG immunotherapy, and the BCG + IAC group received 4 courses of extra intra-arterial chemotherapy. Clinical and follow-up data were recorded and processed using a statistical software. Result The recurrence rate was 14% in the BCG + IAC group and 28.3% in the BCG group, whereas the progression rates were 7% and 8.3%, respectively. In the Kaplan-Meier plot, a statistically significant difference was observed with respect to recurrence-free survival (p = 0.045), while the progression-free survival of the two groups was similar (p = 0.452). 46.5 the patients with adverse effects of IAC and 84.5% patients suffered from adverse reactions to BCG immunotherapy, and most of the adverse effects were mild and tolerable. Univariate analysis indicated that only history of recurrence was an independent risk factor for recurrence. Conclusion Intra-arterial chemotherapy could decrease the recurrence rate of BCG immunotherapy in high-risk patients with NMIBC with little additional toxicity. This could be a promising auxiliary treatment for BCG immunotherapy.