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Objective <p>This study aimed to compare the effects of intravesical Bacillus Calmette-Guérin (BCG) and chemohyperthermia (CHT) with mitomycin C (MMC) therapy on symptom burden, recurrence, and quality of life in patients with high-risk non–muscle-invasive bladder cancer (NMIBC).</p> Methods <p>A total of 116 male patients with high-risk NMIBC were included, comprising 52 treated with BCG and 64 treated with CHT-MMC. Symptom severity was evaluated using the International Prostate Symptom Score (IPSS) and the Overactive Bladder Questionnaire (OAB-V8) before and after treatment. Post-treatment adverse events such as dysuria, hematuria, and pollakiuria were recorded. Quality of life was assessed using the Short Form-12 (SF-12) Health Survey, including the physical (PCS) and mental component summary (MCS) scores. Recurrence rates were monitored during a 24-month follow-up period.</p> Results <p>Following treatment, symptom scores (IPSS and OAB-V8) were significantly worsened in the BCG group compared to the CHT-MMC group (<i>p</i> &lt; 0.01). Dysuria occurred in 84.6% of patients in the BCG group and in 46.2% of those in the CHT-MMC group (<i>p</i> = 0.054). Hematuria was observed in 43.8% and 12.5% of patients in the BCG and CHT-MMC groups, respectively (<i>p</i> = 0.095). The mean PCS score was significantly lower in the BCG group than in the CHT-MMC group (43.9 ± 11.0 vs. 54.9 ± 6.3, <i>p</i> = 0.008), whereas there was no statistically significant difference in MCS scores between the two groups (<i>p</i> = 0.145). Disease recurrence was detected in 22 of 52 patients (42.3%) in the BCG group and in 38 of 64 patients (59.4%) in the CHT-MMC group (<i>p</i> = 0.467).</p> Conclusion <p>Intravesical chemohyperthermia with mitomycin C (CHT-MMC) was associated with a more favorable symptom profile and superior physical quality of life compared to BCG, while no statistically significant difference was observed in recurrence rates. These results indicate that intravesical CHT-MMC may represent a well-tolerated and effective therapeutic alternative for high-risk NMIBC patients who are intolerant to or have contraindications for BCG therapy.</p>

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Comparison of intravesical Bacillus Calmette-Guérin and chemohyperthermia with mitomycin C in with high-risk non–muscle-invasive bladder cancer: a critical assesment focusing on the quality of life and adverse events

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  • 发表日期：

    2026年1月14日

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  • Fahri Yavuz Ilki,
  • Emre Bülbül,
  • Yusuf Kadir Topçu,
  • Ozgur Cinar,
  • Cetin Kocabıyık,
  • Selahattin Bedir

摘要

Objective

This study aimed to compare the effects of intravesical Bacillus Calmette-Guérin (BCG) and chemohyperthermia (CHT) with mitomycin C (MMC) therapy on symptom burden, recurrence, and quality of life in patients with high-risk non–muscle-invasive bladder cancer (NMIBC).

Methods

A total of 116 male patients with high-risk NMIBC were included, comprising 52 treated with BCG and 64 treated with CHT-MMC. Symptom severity was evaluated using the International Prostate Symptom Score (IPSS) and the Overactive Bladder Questionnaire (OAB-V8) before and after treatment. Post-treatment adverse events such as dysuria, hematuria, and pollakiuria were recorded. Quality of life was assessed using the Short Form-12 (SF-12) Health Survey, including the physical (PCS) and mental component summary (MCS) scores. Recurrence rates were monitored during a 24-month follow-up period.

Results

Following treatment, symptom scores (IPSS and OAB-V8) were significantly worsened in the BCG group compared to the CHT-MMC group (p < 0.01). Dysuria occurred in 84.6% of patients in the BCG group and in 46.2% of those in the CHT-MMC group (p = 0.054). Hematuria was observed in 43.8% and 12.5% of patients in the BCG and CHT-MMC groups, respectively (p = 0.095). The mean PCS score was significantly lower in the BCG group than in the CHT-MMC group (43.9 ± 11.0 vs. 54.9 ± 6.3, p = 0.008), whereas there was no statistically significant difference in MCS scores between the two groups (p = 0.145). Disease recurrence was detected in 22 of 52 patients (42.3%) in the BCG group and in 38 of 64 patients (59.4%) in the CHT-MMC group (p = 0.467).

Conclusion

Intravesical chemohyperthermia with mitomycin C (CHT-MMC) was associated with a more favorable symptom profile and superior physical quality of life compared to BCG, while no statistically significant difference was observed in recurrence rates. These results indicate that intravesical CHT-MMC may represent a well-tolerated and effective therapeutic alternative for high-risk NMIBC patients who are intolerant to or have contraindications for BCG therapy.