Efficacy and Safety of Photodynamic Therapy for Recurrent, High Grade Nonmuscle Invasive Bladder Cancer Refractory or Intolerant to Bacille Calmette-Guérin Immunotherapy

No AccessJournal of UrologyAdult Urology1 Oct 2013Efficacy and Safety of Photodynamic Therapy for Recurrent, High Grade Nonmuscle Invasive Bladder Cancer Refractory or Intolerant to Bacille Calmette-Guérin Immunotherapy Joo Yong Lee, Richilda Red Diaz, Kang Su Cho, Meng Shi Lim, Jae Seung Chung, Won Tae Kim, Won Sik Ham, and Young Deuk Choi Joo Yong LeeJoo Yong Lee Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea , Richilda Red DiazRichilda Red Diaz Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea , Kang Su ChoKang Su Cho Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea , Meng Shi LimMeng Shi Lim Department of Urology, Sarawak General Hospital, Kuching, Malaysia , Jae Seung ChungJae Seung Chung Department of Urology, Inje University College of Medicine, Busan, Republic of Korea , Won Tae KimWon Tae Kim Department of Urology, Chungbuk National University College of Medicine, Cheongju, Republic of Korea , Won Sik HamWon Sik Ham Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea , and Young Deuk ChoiYoung Deuk Choi Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Clinical Trial Center for Medical Device, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea View All Author Informationhttps://doi.org/10.1016/j.juro.2013.04.077AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the effectiveness of photodynamic therapy using Radachlorin® in patients with high grade, nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy who refused radical cystectomy. Materials and Methods: Between July 2009 and December 2011 photodynamic therapy was performed in 22 men and 12 women. Radachlorin (0.5 to 0.6 mg/kg) was injected intravenously 2 to 3 hours before photodynamic therapy. After complete transurethral resection, a diffuser using a 22Fr cystoscope was placed in the bladder for irradiation with a 662 nm laser. Output beam power was adjusted to 1.8 W and the light dose was 15 J/cm2. Photodynamic therapy was performed for 16 to 30 minutes. Recurrence after photodynamic therapy was followed by regular cystoscopy at 1, 2 and 3 months, and at 3-month intervals thereafter for up to 2.8 years. Efficacy was assessed by cystoscopy, cytology and histology, and defined as the number of patients who were tumor free after initial photodynamic therapy. Results: Mean ± SD patient age was 62.94 ± 8.71 years. Average followup was 26.74 ± 6.34 months (median 28.12). As the primary efficacy outcome, the recurrence-free rate was 90.9% at 12 months, 64.4% at 24 months and 60.1% at 30 months. As the secondary efficacy outcome, there was no statistical difference in mass size, carcinoma in situ, number of previous bacillus Calmette-Guérin administrations, number of transurethral bladder resections or tumor multiplicity on Kaplan-Meier analysis (each p >0.05). No evidence of severe adverse effects was detected after photodynamic therapy. Conclusions: Photodynamic therapy with Radachlorin is a safe, effective treatment for nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy in select patients. References 1 : Systemic chemotherapy for advanced bladder cancer: update and controversies. J Clin Oncol2006; 24: 5545. Google Scholar 2 : Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol2003; 169: 90. 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Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byNazmifar M, Williams C, Naser-Tavakolian A, Heard J, Rosser C, Theodorescu D and Ahdoot M (2022) Clinical and Preclinical Therapies for Bladder Cancer Following Bacillus Calmette-Guérin FailureJournal of Urology, Volume 190Issue 4October 2013Page: 1192-1199 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordschlorin e6treatment failurephotochemotherapyurinary bladder neoplasmsBCG vaccineAcknowledgmentsRadachlorin was obtained from Rada-Pharma, Moscow, Russia.MetricsAuthor Information Joo Yong Lee Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea More articles by this author Richilda Red Diaz Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea More articles by this author Kang Su Cho Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea More articles by this author Meng Shi Lim Department of Urology, Sarawak General Hospital, Kuching, Malaysia More articles by this author Jae Seung Chung Department of Urology, Inje University College of Medicine, Busan, Republic of Korea More articles by this author Won Tae Kim Department of Urology, Chungbuk National University College of Medicine, Cheongju, Republic of Korea More articles by this author Won Sik Ham Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea More articles by this author Young Deuk Choi Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea Clinical Trial Center for Medical Device, Yonsei University College of Medicine, Seoul, Republic of Korea Severance Hospital and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea More articles by this author Expand All Advertisement PDF downloadLoading ...