Analysis of the results of intravesical perfusion therapy combined with immediate or non-immediate hematoporphyrin intravesical perfusion photodynamic therapy (PDT) after TURBT for NMIBC.

Abstract

e16593 Background: NMIBC has a high postoperative recurrence rate. Therefore, Hematoporphyrin intravesical perfusion PDT being explored to reduce the recurrence rate. Currently, there are two treatment strategies: immediate and non-immediate hematoporphyrin intravesical perfusion PDT. This Study is to explore the differences in prevention of bladder cancer recurrence and safty between the two groups. Methods: Patients with NMIBC Were enrolled. Group 1: Immediate intravesical perfusion of hematoporphyrin combined with PDT refers to the injection of 50-75mg of hematoporphyrin injection + 30ml of saline into the bladder immediately after TURBT, followed by PDT after 60 minutes of retention. The light source wavelength is 660nm, the output power is 1800W, and the irradiation time is 26 minutes, with a light dose of 20J/cm². Group 2: Non-immediate intravesical perfusion of hematoporphyrin combined with PDTrefers to the injection of 50-75 mg of hematoporphyrin injection + 30ml of saline into the bladder 4-12 weeks after TURBT, followed by PDT after 120 minutes of retention. The light source wavelength is 660nm, the output power is 1800W, and the irradiation time is 26 minutes, with a light dose of 20J/cm². After PDT, cystoscopy, pelvic CT/MRI, and urine cytology were routinely rechecked every 3 months. The primary endpoint were the recurrence-free survival (RFS) rate at 3, 6, 12, 18 and 24 months, progression-free survival (PFS) rate and AEs. Results: 86 patients with NMIBC were enrolled and who received intravesical perfusion therapy combined with hematoporphyrin intravesical perfusion PDT from August 2016 to July 2024 were enrolled. Among them,There were 33 pts in Group 1 (immediate treatment group) and 53 pts in Group 2 (non-immediate treatment group). There were no differences in age, gender, pathological grade, T stage, risk stratification, tumor recurrence score, tumor progression score, the number of recurrences before treatment, and concurrent carcinoma in situ between the two groups (all P > 0.05). The median follow-up was 51.4 months. The 3, 6, 12, 18 and 24 month recurrence rates of Group 1 and Group 2 were 12.1% and 7.5% (P = 0.48), ,18.2% and 15.1% (P = 0.77), 24.2% and 20.8% (P = 0.79), 30.3% and 22.6% (P = 0.59) and 33.3% and 24.5% (P = 0.52), respectively. The incidence of adverse reactions in Group 1 and Group 2 was 9.1% and 18.9% (P = 0.36).. The main AEs were mild dysuria, frequent urination and other discomforts, all of which could be relieved. No severe bladder spasm or systemic photosensitivity reactions were observed. Conclusions: There was no statistically significant difference in AEs and in the recurrence rate of bladder cancer within 3 to 24 months after TURBT for NMIBC between two groups. Clinically, the choice can be made based on the actual situation.