Abroad, patients with high-risk non-muscle invasive bladder cancer (NMIBC) often require supplemental BCG infusion therapy after surgical treatment to reduce the risk of tumor recurrence and progression. According to the European Association of Urology guidelines, the standard BCG infusion regimen is once a week for 6 weeks, in addition to a minimum of 1 year of BCG maintenance infusion. a long course of BCG maintenance infusion for 3 years can further reduce disease recurrence and progression, but is accompanied by greater side effects. Recently, in order to compare whether standard BCG perfusion followed by 3-year maintenance perfusion therapy is superior to standard perfusion therapy alone, Luis and others at the Princess Sofia Hospital in Spain conducted a clinical study and found that in patients with high-risk NMIBC, BCG maintenance perfusion therapy every 3 months for 3 years was not significantly more effective than standard BCG perfusion alone. The study, published in a recent issue of European Urology, found no significant difference in the efficacy of BCG maintenance perfusion once every 3 months for 3 years compared with standard BCG perfusion alone in patients with high risk NMIBC. A total of 397 patients with high-risk NMIBC were enrolled in the study. Patients were divided into two groups: those who received standard BCG infusion only once a week for 6 weeks were in the non-maintenance group (195), and those who continued standard infusion once every 3 months for 3 years were in the maintenance group (202). The main observation indexes were tumor-free interval (DFI) and time to tumor progression (TTP), and other indexes included survival time and toxic effects. The results showed that the DFI time was similar in the maintenance perfusion group and the non-maintenance perfusion group, and the 5-year disease recurrence rate was 33.5% and 38.5%, respectively. Similarly, TTP did not differ significantly between the two treatment groups, with 5-year progression rates of 16% and 19.5%, respectively. There were no significant differences between the two treatment groups in terms of overall survival time or 5-year tumor-specific survival. In addition, there were 20 and 5 discontinuations due to drug toxicity in the two groups, respectively. Common local side effects included dysuria (65%), dyspareunia (63%), and hematuria (43%), while systemic side effects were most commonly systemic discomfort (7.2%) and fever (34%). Many studies have shown that BCG infusion every 3 months is sufficient to maintain the antitumor effect of local immune responses in the bladder, so that BCG infusion every 3 months after 6 weeks of standard infusion provides sufficient immune stimulation to avoid tumor recurrence and metastasis. In this study, in patients with NMIBC, standard BCG induction perfusion followed by BCG maintenance perfusion therapy every 3 months for 3 years did not reduce disease recurrence and progression compared with standard perfusion alone. the efficacy of BCG long-course maintenance perfusion remains to be further investigated. Source: Ding Xiang Yuan Author: Tang