Various intravesical therapies have been introduced into clinical practices for controlling non-muscle invasive bladder cancer (NMIBC). However, evidence with respect to the efficacy and safety of those intravesical therapies is very limited. Hence, we present a network meta-analysis in order to address this limitation in the current literature. The primary outcomes were the risk of tumor recurrence (TR), tumor progression (TP) and disease-specific mortality (DM). Secondary outcomes included the risk of fever, cystitis and haematuria. Conventional pair-wise and network meta-analysis were both performed for each endpoint. The surface under the cumulative ranking curve (SUCRA) was incorporated in our analysis for ranking the corresponding intravesical instillation interventions. In total, 23 randomized clinical trials (RCTs) were finally included in our study after irrelevant papers were screened out. Results of network meta-analysis suggested that Epirubicin (EPI) was less preferable than Bacille Calmette Guerin (BCG), BCG+EPI, BCG+ Isoniazid (INH), BCG+ Mytomicin C (MMC), Gemcitabine (GEM) and MMC with respect to TR. As suggested by the corresponding ranking probabilities and SUCRA, incorporating EPI or MMC into BCG may enhance the efficacy of BCG monotherapy.
Oncotarget. 2016 Oct 24 [Epub ahead of print]
Chuanjun Zhuo, Xubin Li, Hongqing Zhuang, Shunli Tian, Hailong Cui, Ronghuan Jiang, Chuanxin Liu, Ran Tao, Xiaodong Lin
Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325005, China., Department of Radiotherapy, Tianjin Cancer Institute and Hospital, Tianjin, 30000, China., Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, 300075, China., Intensive Care Unit, Tianjin Medical University General Hospital, Tianjin, 300075, China., Department of Psychological Medicine, Chinese PLA (People's Liberation Army) General Hospital, Department of Psychological Medicine, Chinese PLA (People's Liberation Army) Medical School, Beijing, 100853, China., Department of Psychological Medicine, Jining Medical University, Jining, Shandong, 272067, China., Beijing Shijian Integrated Medicine Science Institute, Beijing, 100700, China.