Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations

Adverse events induced by intravesical bacillus Calmette-Guérin (BCG) to treat high-grade non-muscle-invasive bladder cancer (NMIBC) often lead to treatment discontinuation. The EAU-RF NIMBUS trial found a reduced number of standard-dose BCG instillations to be inferior with the standard regimen. No...

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Autores: van Straten, Christine G.J.I., Caris, Christien, Grimm, Marc-Oliver|||0000-0003-3084-8654, Colombel, Marc, Muilwijk, Tim|||0000-0002-6965-389X, Martínez-Piñeiro, Luis, Babjuk, Marek|||0000-0002-3115-7428, Türkeri, Levent N., Palou, Juan|||0000-0003-1264-5327, Patel, Anup, Bjartell, Anders S., Witjes, Wim P.J.|||0000-0002-3600-7920, van der Heijden, Antoine G., Kiemeney, Lambertus A.L.M.|||0000-0002-2368-1326
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:303889
Acceso en línea:https://ddd.uab.cat/record/303889
https://dx.doi.org/urn:doi:10.1016/j.euros.2023.08.004
Access Level:acceso abierto
Palabra clave:Bacillus Calmette-Guérin
Bladder cancer
High-grade non-muscle-invasive bladder cancer
Quality of life
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repository_id_str
dc.title.none.fl_str_mv Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
The EAU-RF NIMBUS Trial
title Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
spellingShingle Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
van Straten, Christine G.J.I.
Bacillus Calmette-Guérin
Bladder cancer
High-grade non-muscle-invasive bladder cancer
Quality of life
title_short Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
title_full Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
title_fullStr Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
title_full_unstemmed Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
title_sort Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin Instillations
dc.creator.none.fl_str_mv van Straten, Christine G.J.I.
Caris, Christien
Grimm, Marc-Oliver|||0000-0003-3084-8654
Colombel, Marc
Muilwijk, Tim|||0000-0002-6965-389X
Martínez-Piñeiro, Luis
Babjuk, Marek|||0000-0002-3115-7428
Türkeri, Levent N.
Palou, Juan|||0000-0003-1264-5327
Patel, Anup
Bjartell, Anders S.
Witjes, Wim P.J.|||0000-0002-3600-7920
van der Heijden, Antoine G.
Kiemeney, Lambertus A.L.M.|||0000-0002-2368-1326
author van Straten, Christine G.J.I.
author_facet van Straten, Christine G.J.I.
Caris, Christien
Grimm, Marc-Oliver|||0000-0003-3084-8654
Colombel, Marc
Muilwijk, Tim|||0000-0002-6965-389X
Martínez-Piñeiro, Luis
Babjuk, Marek|||0000-0002-3115-7428
Türkeri, Levent N.
Palou, Juan|||0000-0003-1264-5327
Patel, Anup
Bjartell, Anders S.
Witjes, Wim P.J.|||0000-0002-3600-7920
van der Heijden, Antoine G.
Kiemeney, Lambertus A.L.M.|||0000-0002-2368-1326
author_role author
author2 Caris, Christien
Grimm, Marc-Oliver|||0000-0003-3084-8654
Colombel, Marc
Muilwijk, Tim|||0000-0002-6965-389X
Martínez-Piñeiro, Luis
Babjuk, Marek|||0000-0002-3115-7428
Türkeri, Levent N.
Palou, Juan|||0000-0003-1264-5327
Patel, Anup
Bjartell, Anders S.
Witjes, Wim P.J.|||0000-0002-3600-7920
van der Heijden, Antoine G.
Kiemeney, Lambertus A.L.M.|||0000-0002-2368-1326
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Bacillus Calmette-Guérin
Bladder cancer
High-grade non-muscle-invasive bladder cancer
Quality of life
topic Bacillus Calmette-Guérin
Bladder cancer
High-grade non-muscle-invasive bladder cancer
Quality of life
description Adverse events induced by intravesical bacillus Calmette-Guérin (BCG) to treat high-grade non-muscle-invasive bladder cancer (NMIBC) often lead to treatment discontinuation. The EAU-RF NIMBUS trial found a reduced number of standard-dose BCG instillations to be inferior with the standard regimen. Nonetheless, it remains important to evaluate whether patients in the reduced BCG treatment arm had better quality of life (QoL) due to a possible reduction in toxicity or burden. To evaluate whether patients in the EAU-RF NIMBUS trial experienced better QoL after a reduced BCG instillation frequency. Design, setting, and participants: A total of 359 patients from 51 European sites were randomized to one of two treatment arms between December 2013 and July 2019. The standard frequency arm (n = 182) was 6 weeks of BCG induction followed by 3 weeks of maintenance at months 3, 6, and 12. The reduced frequency arm (n = 177) was BCG induction at weeks 1, 2, and 6, followed by maintenance instillations at weeks 1 and 3 of months 3, 6, and 12. Outcome measurements and statistical analysis: Analyses were performed using an intention-to-treat analysis and a per-protocol analysis. QoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 version 3.0 (QLQ-C30 v.03) prior to the first and last instillations of each BCG cycle. Group differences were determined using linear regression corrected for QoL at baseline. Differences in QoL over time were tested for significance using a linear mixed model. Side effects were recorded by the treating physician using a standardized form. Chi-square tests were used to compare the side-effect frequency between the arms. There were no significant differences in the means of each QoL scale between the two arms. There were also no significant changes over time in all QoL domains for both arms. However, differences in the incidence of general malaise at T1 (before the last induction instillation), frequency, urgency, and dysuria at T7 (before the last maintenance instillation) were detected in favor of the reduced frequency arm. Reducing the BCG instillation frequency does not improve the QoL in NMIBC patients despite lower storage symptoms. In this study, we evaluated whether a reduction in the number of received bacillus Calmette-Guérin instillations led to better quality of life in patients with high-grade non-muscle-invasive bladder cancer. We found no difference in the quality of life between the standard and the reduced bacillus Calmette-Guérin instillation frequency. We conclude that reducing the number of instillations does not lead to better quality of life in patients with high-grade non-muscle-invasive bladder cancer.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
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VoR
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dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/303889
https://dx.doi.org/urn:doi:10.1016/j.euros.2023.08.004
url https://ddd.uab.cat/record/303889
https://dx.doi.org/urn:doi:10.1016/j.euros.2023.08.004
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
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spelling Quality of Life in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Standard Versus Reduced Frequency of Bacillus Calmette-Guérin InstillationsThe EAU-RF NIMBUS Trialvan Straten, Christine G.J.I.Caris, ChristienGrimm, Marc-Oliver|||0000-0003-3084-8654Colombel, MarcMuilwijk, Tim|||0000-0002-6965-389XMartínez-Piñeiro, LuisBabjuk, Marek|||0000-0002-3115-7428Türkeri, Levent N.Palou, Juan|||0000-0003-1264-5327Patel, AnupBjartell, Anders S.Witjes, Wim P.J.|||0000-0002-3600-7920van der Heijden, Antoine G.Kiemeney, Lambertus A.L.M.|||0000-0002-2368-1326Bacillus Calmette-GuérinBladder cancerHigh-grade non-muscle-invasive bladder cancerQuality of lifeAdverse events induced by intravesical bacillus Calmette-Guérin (BCG) to treat high-grade non-muscle-invasive bladder cancer (NMIBC) often lead to treatment discontinuation. The EAU-RF NIMBUS trial found a reduced number of standard-dose BCG instillations to be inferior with the standard regimen. Nonetheless, it remains important to evaluate whether patients in the reduced BCG treatment arm had better quality of life (QoL) due to a possible reduction in toxicity or burden. To evaluate whether patients in the EAU-RF NIMBUS trial experienced better QoL after a reduced BCG instillation frequency. Design, setting, and participants: A total of 359 patients from 51 European sites were randomized to one of two treatment arms between December 2013 and July 2019. The standard frequency arm (n = 182) was 6 weeks of BCG induction followed by 3 weeks of maintenance at months 3, 6, and 12. The reduced frequency arm (n = 177) was BCG induction at weeks 1, 2, and 6, followed by maintenance instillations at weeks 1 and 3 of months 3, 6, and 12. Outcome measurements and statistical analysis: Analyses were performed using an intention-to-treat analysis and a per-protocol analysis. QoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 version 3.0 (QLQ-C30 v.03) prior to the first and last instillations of each BCG cycle. Group differences were determined using linear regression corrected for QoL at baseline. Differences in QoL over time were tested for significance using a linear mixed model. Side effects were recorded by the treating physician using a standardized form. Chi-square tests were used to compare the side-effect frequency between the arms. There were no significant differences in the means of each QoL scale between the two arms. There were also no significant changes over time in all QoL domains for both arms. However, differences in the incidence of general malaise at T1 (before the last induction instillation), frequency, urgency, and dysuria at T7 (before the last maintenance instillation) were detected in favor of the reduced frequency arm. Reducing the BCG instillation frequency does not improve the QoL in NMIBC patients despite lower storage symptoms. In this study, we evaluated whether a reduction in the number of received bacillus Calmette-Guérin instillations led to better quality of life in patients with high-grade non-muscle-invasive bladder cancer. We found no difference in the quality of life between the standard and the reduced bacillus Calmette-Guérin instillation frequency. We conclude that reducing the number of instillations does not lead to better quality of life in patients with high-grade non-muscle-invasive bladder cancer.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/303889https://dx.doi.org/urn:doi:10.1016/j.euros.2023.08.004reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3038892026-06-06T12:50:31Z
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