표재성 방광암의 방광내 주입요법: 최근 발전 동향과 미래 대책

Abstract

Superficial bladder tumor accounts for approximately 70% to 80% of all newly diagnosed bladder cancers. The primary treatment for superficial bladder cancer is transurethral resection (TUR) of the tumors. Many patients treated with endoscopic surgery alone gave recurrence or tumor progression at some point in their follow-up, and, in these patients, the need for adjuvant treatment becomes a major concern. BCG immunotherapy not only reduces recurrences of superficial bladder tumor but also decreases stage progression, radical cystectomy rates, and disease-specific mortality. Controlled comparative studies have shown that BCG is superior to intravesical chemotherapy, especially in carcinoma in situ where a complete response is seen in more than 70% of patients and the 5-year disease-free interval averages 40%. I believe that BCG is superior to intravesical chemotherapy even in the treatment of patients with recurrent Stage Ta or T1 tumors. Until now, intravesical chemotherapy is appropriate for instillation at the time of surgery in an attempt to reduce recurrence or as a second-line therapy for patients in whom BCG immunotherapy has failed. Newer immunologic and chemotherapy agents, advances in photodynamic therapy, and other measures to boost the efficacy of intravesical therapy for superficial bladder cancer demonstrate potential, but much work remains to be done in these areas. Key word : Superficial bladder tumor, Intravesical therapy, BCG, Chemotherapy