bcg膀胱灌药protocol (chen 20111001) - ntuhgovtw.pdf

Protocols of Intravesical Chemoimmunotherapy to Prevent Recurrence of Superficial Bladder Cancer 臺大醫院泌尿部 陳忠信醫師 2011 年10月 1日校正 Mitomycin-C (30 mg) Bladder instillation within 24 hours of TUR-BT (as early as possible). ⇓ BCG weekly for 3 weeks starting at one week after TUR-BT, i.e. 2nd, 3rd, and 4th after TUR-BT. **If gross hematuria persists after TUR, please hold BCG irrigation. ⇓ BCG weekly for 3 weeks, if cystoscopy is negative at 3 months. ⇓ BCG weekly for 3 weeks after each negative cystoscopy at 6, 12, 18, 24, 30, 36 months. BCGx3 at 3, 6, 12, 18, 24, 30, 36, 48, and 60 months, if the follow-up cystoscopy is negative. Plus IVP (or MRU for poor renal function) every 12 month to detect upper tract UC Note 1. BCG dose: 81 mg (dry weight, Connaught strain) 2. This protocol is designed for superficial bladder cancer (including carcinoma in situ), not for muscle-invasive one. Superficial tumor status should be documented or ruled out by the pathology. 3. Mitomycin-C should be delayed until hematuria reduced to an 1 extent that holding N/S continuous irrigation will NOT result in blood clot obstruction or retention. 4. When giving mitomycin-C, hold post-op N/S irrigation temporarily and retain mitomycin-C for at least one hour in the bladder. Drain out the drug through the Foley catheter then continue N/S irrigation if necessary. 5. Mitomycin-C should not be given when suspicious or minimal bladder perforation has been noted during TUR-BT. When