Background/Objectives: Non-muscle-invasive bladder cancer (NMIBC) is a common form of bladder cancer with a significant risk of recurrence and progression, especially in intermediate- and high-risk patients. Bacillus Calmette–Guérin (BCG) therapy has been the gold standard, but its limitations have prompted the exploration of alternative therapies. This study aims to compare the long-term effectiveness of two such alternatives—hyperthermia-induced potentiation of mitomycin C (HIVEC) and electromotive drug administration (EMDA)—in preventing recurrence and progression in NMIBC patients.Methods: A prospective observational study was conducted at a Spanish center, including patients with intermediate- and high-risk NMIBC who were treated between August 2018 and December 2024. Participants were allocated to receive either HIVEC or EMDA based on their preferences. Both treatments followed a similar protocol, with an initial induction phase and maintenance sessions. Patient follow-up included regular cystoscopy, cytology, and imaging.Results: At 36 months, the disease-free survival rate was 62.4% for the HIVEC group and 67% for the EMDA group. Statistical analysis showed no significant difference between the two groups in terms of long-term efficacy. The adjusted hazard ratio for the treatment effect was 0.95, indicating comparable outcomes.Conclusions: Both HIVEC and EMDA demonstrate similar long-term efficacy in preventing recurrence and progression in intermediate- and high-risk NMIBC. These findings suggest that both treatments show promise as potential future options for managing NMIBC, providing clinicians with additional considerations based on patient characteristics and preferences. Further studies, particularly randomized controlled trials, are needed to confirm these results and optimize treatment protocols.
背景/目的：非肌层浸润性膀胱癌是一种常见的膀胱癌类型，具有显著的复发和进展风险，尤其在中高危患者中。卡介苗疗法一直是金标准，但其局限性促使人们探索替代疗法。本研究旨在比较两种替代疗法——热疗增强丝裂霉素C灌注与电动力药物灌注——在预防非肌层浸润性膀胱癌患者复发和进展方面的长期有效性。 方法：在西班牙一家中心开展了一项前瞻性观察研究，纳入2018年8月至2024年12月期间接受治疗的中高危非肌层浸润性膀胱癌患者。根据患者偏好，参与者被分配接受热疗增强丝裂霉素C灌注或电动力药物灌注治疗。两种治疗方案相似，均包括初始诱导阶段和维持治疗阶段。患者随访包括定期膀胱镜检查、细胞学检查和影像学检查。 结果：36个月时，热疗增强丝裂霉素C灌注组的无病生存率为62.4%，电动力药物灌注组为67%。统计分析显示两组在长期疗效方面无显著差异。治疗效果的调整后风险比为0.95，表明两种疗法效果相当。 结论：热疗增强丝裂霉素C灌注和电动力药物灌注在预防中高危非肌层浸润性膀胱癌复发和进展方面表现出相似的长期疗效。这些发现表明，两种疗法均有潜力成为未来治疗非肌层浸润性膀胱癌的选择，为临床医生根据患者特征和偏好提供了更多考量。需要进一步研究，特别是随机对照试验，以确认这些结果并优化治疗方案。
肿瘤(癌症)患者之家