Yüzeyel mesane tümörlerinde TUR sonrası intrakaviter BCG uygulaması ve uzun süreli idamesinin rekürrens ve progresyon üzerindeki etkisi

Yüzeyel mesane tümörlerinde TUR sonras intrakaviter BCG uygulamasının rekürrens ve progresyon üzerindeki etkisi bilinmektedir ancak idame tedavisinin süresi konusunda tartışmalar bulunmaktadır. Haziran 1996- Aralık 1999 tarihleri arasında yü - zeyel mesane tümür tanısı almış 69 hastaya TUR sonrası intrakaviter BCG uygulayarak elde edilen sonuçlar değerlendirildi. Intrakaviter BCG tedavisi, standart 6 haftalık tedaviye ek olarak, 3 ay boyunca ayda bir tek doz, daha sonra ise 2 yıl boyunca 6 ayda bir tek doz eklinde uygulandı . Intrakaviter BCG proflaksisi altındayken hastalar n %21.73 de rekürrens, %7.2 sinde progresyon saptandı . Rekürrenslerin özellikle ilk 1 yıl içinde sık oldu ğu gözlendi. BCG ye bağlı görülen yan etkilerin, profilaktik rifampisin uygulamasıyla ve uygun medikal tedaviyle çoğu hastada tolere edildiği tesbit edildi. Sonu olarak intrakaviter BCG uygulaması ve uzun süreli idamesi, TUR sonras rekürrens ve progresyon için etkin profilaksi sağlayan, yan etkileri kabul edilebilir düzeyde olan, güvenilir bir immunoterapi yöntemidir. TUR sonras BCG tedavi şemaları arasında ideal tedaviyi saptayabilmek için karşılaştırmalı , uzun süreli çalışmalara ihtiyaç bulunmaktadır

Intravesical BCG application term maintenance

Altough the discussion on the appropriate duration of proflaxy continues, the effect of BCG on the reccurence and progression of superficial bladder tumors is wellknown. The results of 69 patients who had BCG proflaxy after TUR due to superficial bladder tumors, have been evaluated. n addition to the standard 6 weeks intravesical therapy, 3 months once a month followed by a once in every 6 months for 2 years BCG maintenance proflaxy have been applied. Under intravesical BCG proflaxy, %21.73 of patients had recurerence whereas %7.2 had progression. Recurrence have been observed significantly frequent in the first year after surgery. Side effects due to BCG had been well tolerated with the riphampicine proflaxy and apropriate medical treatment in most of the patients. As a result intrevesical BCG aplication and long term maintenance proflaxy is a safe, well tolerated immunotherapeutic method for the proflaxy of recurrence and progression of superficial bladder tumors after TUR.

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