Bladder cancer is one of the common malignant tumors, and 70-80% of them are superficial bladder cancer. Although most bladder tumors can be cured by surgical resection, 50%-70% of superficial bladder cancers still recur within 1 year after surgery, and 60%-90% recur within 3-5 years. Therefore, adjuvant therapy has an extremely important role for patients with bladder cancer.
To prevent recurrence of superficial bladder cancer after TURBT, bladder perfusion therapy is often chosen. Clinically available drugs include chemotherapeutic agents, immunomodulators and cytokines, etc. Hendricksen et al. randomized 1000 SBC patients mostly with TaG1-2 into 3 different EPI treatment groups, and the 5-year follow-up resulted in only 44% of patients not recurring and 88.6% not progressing, and there was no significant difference between the 3 groups.
Then, how to reduce the postoperative recurrence rate of bladder cancer patients, how to prolong the recurrence time of patients, and how to further improve the quality of life of patients are questions that deserve to be explored in depth.
Thermochemical perfusion therapy is a method that combines heat therapy with perfusion chemotherapy. The thermotherapy system can raise the bladder wall temperature to 42-43°C, which not only can directly kill tumor cells or trigger their apoptosis, but also dilate the blood vessels of tumor tissues, increase the membrane permeability of chemotherapeutic drugs, increase the concentration of drugs in the cytoplasm of tumor cells, and reverse the multidrug resistance of certain chemotherapeutic drugs, etc. In a multicenter study by Witjes et al. patients) achieved biopsy- and cytology-confirmable remission in 94% of patients treated with thermal chemoinfusion, and the adverse effects were mild and transient. In addition, warmth has a strong killing effect on S-phase cells, whereas chemotherapeutic agents are effective in suppressing non-S-phase cells. It can be seen that warm chemotherapy can better control postoperative recurrence of superficial bladder cancer and prevent tumor spread and metastasis.
Therefore, the addition of local thermotherapy along with bladder instillation chemotherapy will likely play a synergistic and synergistic role to effectively prevent the recurrence of superficial bladder cancer after TURBT, further improve patients’ quality of life and prolong their survival.