Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

Background: The efficacy of intravesical chemotherapy maintenance for patients with non-muscle invasive bladder cancer (NMIBC) is inferior compared to intravesical bacillus Calmette–Guerin (BCG). How intravesical chemohyperthermia (CHT) compares with BCG is under investigation.Objective: To compare...

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Autores principales:	Hongda Zhao, Vinson Wai-Shun Chan, Daniele Castellani, Erica On-Ting Chan, William Lay Keat Ong, Qiang Peng, Marco Moschini, Wojciech Krajewski, Benjamin Pradere, Chi-Fai Ng, Dmitry Enikeev, Nikhil Vasdev, Gokhan Ekin, Alejandro Sousa, Juan Leon, Felix Guerrero-Ramos, Wei-Shen Tan, John Kelly, Shahrokh F. Shariat, J. Alfred Witjes, Jeremy Yuen-Chun Teoh
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	bladder cancer TURBT (trans-urethral resection of bladder tumour) BCG–Bacillus Calmette-Guérin vaccine chemohyperthermia meta-analysis Surgery RD1-811
Acceso en línea:	https://doaj.org/article/f13c4712479b48ccb0d6f76975d30a61
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spelling	oai:doaj.org-article:f13c4712479b48ccb0d6f76975d30a612021-11-30T12:04:56ZIntravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis2296-875X10.3389/fsurg.2021.775527https://doaj.org/article/f13c4712479b48ccb0d6f76975d30a612021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.775527/fullhttps://doaj.org/toc/2296-875XBackground: The efficacy of intravesical chemotherapy maintenance for patients with non-muscle invasive bladder cancer (NMIBC) is inferior compared to intravesical bacillus Calmette–Guerin (BCG). How intravesical chemohyperthermia (CHT) compares with BCG is under investigation.Objective: To compare the oncological outcomes and safety profile between intravesical CHT and BCG treatment for intermediate- and high-risk NMIBC.Methods: We performed a systematic review and meta-analysis of clinical studies comparing CHT with BCG for intermediate- and high-risk NMIBC patients. A comprehensive literature search on OVID MEDLINE, EMBASE, and Cochrane Library was conducted. Risk of bias was assessed by the Cochrane RoB tool and ROBINS-I. Certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.Results: A total of 2,375 articles were identified and five studies were finally included. Among them, four randomised trials comprising 327 patients (CHT group: 156 patients; BCG group: 171 patients) were included in the meta-analysis. There were no significant differences in the 24–36 months recurrence rates (CHT: 29.5%, BCG: 37.4%; RR: 0.83, 95% CI 0.61–1.13; moderate certainty of evidence) and the 24–36 months progression rates (CHT: 4.4%, BCG: 7.6%, RR = 0.62, 95% CI 0.26–1.49; low certainty of evidence). There were also no significant differences in grade 1–2 adverse events (CHT group: 59.9%, BCG group 54.5%; RR = 1.10, 95% CI 0.93–1.30; moderate certainty of evidence) and grade 3 or above adverse events (CHT group: 23.2%, BCG group 22.5%; RR = 0.99, 95% CI 0.69–1.43; low certainty of evidence).Conclusions: Intravesical CHT had equivalent oncological outcomes and similar safety profile when compared to BCG maintenance therapy for patients with intermediate- and high-risk NMIBC. CHT is a possible alternative treatment in the times of BCG shortage.Hongda ZhaoVinson Wai-Shun ChanDaniele CastellaniErica On-Ting ChanWilliam Lay Keat OngQiang PengMarco MoschiniWojciech KrajewskiBenjamin PradereChi-Fai NgDmitry EnikeevNikhil VasdevGokhan EkinAlejandro SousaJuan LeonFelix Guerrero-RamosWei-Shen TanWei-Shen TanWei-Shen TanJohn KellyJohn KellyShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatJ. Alfred WitjesJeremy Yuen-Chun TeohFrontiers Media S.A.articlebladder cancerTURBT (trans-urethral resection of bladder tumour)BCG–Bacillus Calmette-Guérin vaccinechemohyperthermiameta-analysisSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bladder cancer TURBT (trans-urethral resection of bladder tumour) BCG–Bacillus Calmette-Guérin vaccine chemohyperthermia meta-analysis Surgery RD1-811
spellingShingle	bladder cancer TURBT (trans-urethral resection of bladder tumour) BCG–Bacillus Calmette-Guérin vaccine chemohyperthermia meta-analysis Surgery RD1-811 Hongda Zhao Vinson Wai-Shun Chan Daniele Castellani Erica On-Ting Chan William Lay Keat Ong Qiang Peng Marco Moschini Wojciech Krajewski Benjamin Pradere Chi-Fai Ng Dmitry Enikeev Nikhil Vasdev Gokhan Ekin Alejandro Sousa Juan Leon Felix Guerrero-Ramos Wei-Shen Tan Wei-Shen Tan Wei-Shen Tan John Kelly John Kelly Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat J. Alfred Witjes Jeremy Yuen-Chun Teoh Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis
description	Background: The efficacy of intravesical chemotherapy maintenance for patients with non-muscle invasive bladder cancer (NMIBC) is inferior compared to intravesical bacillus Calmette–Guerin (BCG). How intravesical chemohyperthermia (CHT) compares with BCG is under investigation.Objective: To compare the oncological outcomes and safety profile between intravesical CHT and BCG treatment for intermediate- and high-risk NMIBC.Methods: We performed a systematic review and meta-analysis of clinical studies comparing CHT with BCG for intermediate- and high-risk NMIBC patients. A comprehensive literature search on OVID MEDLINE, EMBASE, and Cochrane Library was conducted. Risk of bias was assessed by the Cochrane RoB tool and ROBINS-I. Certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.Results: A total of 2,375 articles were identified and five studies were finally included. Among them, four randomised trials comprising 327 patients (CHT group: 156 patients; BCG group: 171 patients) were included in the meta-analysis. There were no significant differences in the 24–36 months recurrence rates (CHT: 29.5%, BCG: 37.4%; RR: 0.83, 95% CI 0.61–1.13; moderate certainty of evidence) and the 24–36 months progression rates (CHT: 4.4%, BCG: 7.6%, RR = 0.62, 95% CI 0.26–1.49; low certainty of evidence). There were also no significant differences in grade 1–2 adverse events (CHT group: 59.9%, BCG group 54.5%; RR = 1.10, 95% CI 0.93–1.30; moderate certainty of evidence) and grade 3 or above adverse events (CHT group: 23.2%, BCG group 22.5%; RR = 0.99, 95% CI 0.69–1.43; low certainty of evidence).Conclusions: Intravesical CHT had equivalent oncological outcomes and similar safety profile when compared to BCG maintenance therapy for patients with intermediate- and high-risk NMIBC. CHT is a possible alternative treatment in the times of BCG shortage.
format	article
author	Hongda Zhao Vinson Wai-Shun Chan Daniele Castellani Erica On-Ting Chan William Lay Keat Ong Qiang Peng Marco Moschini Wojciech Krajewski Benjamin Pradere Chi-Fai Ng Dmitry Enikeev Nikhil Vasdev Gokhan Ekin Alejandro Sousa Juan Leon Felix Guerrero-Ramos Wei-Shen Tan Wei-Shen Tan Wei-Shen Tan John Kelly John Kelly Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat J. Alfred Witjes Jeremy Yuen-Chun Teoh
author_facet	Hongda Zhao Vinson Wai-Shun Chan Daniele Castellani Erica On-Ting Chan William Lay Keat Ong Qiang Peng Marco Moschini Wojciech Krajewski Benjamin Pradere Chi-Fai Ng Dmitry Enikeev Nikhil Vasdev Gokhan Ekin Alejandro Sousa Juan Leon Felix Guerrero-Ramos Wei-Shen Tan Wei-Shen Tan Wei-Shen Tan John Kelly John Kelly Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat J. Alfred Witjes Jeremy Yuen-Chun Teoh
author_sort	Hongda Zhao
title	Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis
title_short	Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis
title_full	Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis
title_fullStr	Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis
title_full_unstemmed	Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis
title_sort	intravesical chemohyperthermia vs. bacillus calmette-guerin instillation for intermediate- and high-risk non-muscle invasive bladder cancer: a systematic review and meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f13c4712479b48ccb0d6f76975d30a61
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Intravesical Chemohyperthermia vs. Bacillus Calmette-Guerin Instillation for Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

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