Background/Objectives: Knowledge of the symptoms and side effects (SSEs) of Bacille Calmette–Guerin (BCG) therapy for non-muscle invasive bladder cancer (NMIBC) is critical when establishing selecting appropriate therapies for patients. The aim of our study was to systematically review the common patient-reported SSEs associated with BCG-based and other intravesical chemotherapy treatment options for NMIBC. Methods: A systematic search of AMED, MEDLINE, EMBASE, PsycINFO, Web of Knowledge, and Scopus was conducted from inception to July 2024. The PRISMA process was followed. Prospective studies with an adult cohort that assessed SSEs through direct patient reports with standardized patient-reported outcome measures were included in this study. A narrative synthesis was performed to compare the frequency of SSEs reported by treatment options. Statistical analysis was performed using chi square and Fisher’s exact tests, with statistical significance atp< 0.05. Results: Thirty-four studies met the eligibility criteria. The main findings indicated that BCG induction is more toxic than BCG induction with maintenance; however, severe SSEs resulting in treatment cessation occurred almost twice as often in patients on BCG induction with maintenance. Patients who received full-dose BCG were more likely to have SSEs compared to those receiving a low dose. BCG monotherapy alone caused more SSEs compared to BCG with chemotherapy. Patients reported more SSEs with BCG compared to chemotherapy alone for induction with maintenance. Limitations of the study include the varied length of maintenance regimes affecting nature of data reported. Conclusions: The findings of this study allow for improved counselling of patients regarding expected side effects in accordance with their recommended treatment options for NMIBC.
背景/目的：在为非肌层浸润性膀胱癌患者选择合适治疗方案时，了解卡介苗治疗的症状与副作用至关重要。本研究旨在系统综述非肌层浸润性膀胱癌患者在接受卡介苗治疗及其他膀胱灌注化疗方案时自我报告的症状与副作用。方法：系统检索AMED、MEDLINE、EMBASE、PsycINFO、Web of Knowledge及Scopus数据库自建库至2024年7月的文献，遵循PRISMA流程。纳入采用标准化患者报告结局指标直接收集成人患者症状与副作用报告的前瞻性研究，通过叙述性综合比较不同治疗方案的症状与副作用发生率，采用卡方检验与Fisher精确检验进行统计分析（显著性水平p<0.05）。结果：共34项研究符合纳入标准。主要发现表明：卡介苗诱导治疗比卡介苗诱导联合维持治疗更具毒性；但导致治疗中止的严重症状与副作用在诱导联合维持治疗患者中发生率近乎翻倍。与低剂量组相比，全剂量卡介苗治疗患者更易出现症状与副作用。相较于卡介苗联合化疗，单用卡介苗治疗引发更多症状与副作用。在诱导联合维持治疗方案中，患者报告卡介苗治疗比单纯化疗产生更多症状与副作用。研究局限性包括维持治疗方案时长差异影响数据报告性质。结论：本研究结果有助于根据非肌层浸润性膀胱癌患者的推荐治疗方案，为其提供更精准的预期副作用咨询。
肿瘤(癌症)患者之家