Combined Low-Dose Intravesical Immunotherapy (BCG + Interferon a-2b) in the Management of Superficial Transitional Cell Carcinoma of the Urinary Bladder: A Five-Year Follow-Up

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Abstract
Between July 1994 and July 2001, all patients with superficial transitional cell carcinoma (TCC) of urinary bladder (pT1 and pTa), 7 days after undergoing transurethral resection of tumor were subjected to intravesical instillation of 60 mg BCG (Danish 1331) combined with 5 million IU interferon alpha-2b (Intron-A) mixed with 50 ml of physiological saline weekly for 8 weeks, then fortnightly for 8 weeks, then monthly for 8 weeks, followed by maintenance dose at the end of the 9th, 12th, 18th, 24th months. Each instillation was for 2 h duration with an average follow-up period of 60 months. At the end of the 1st year of follow-up 84% of patients had no tumor recurrence which dropped to 36% at the end of 5-year follow-up, while no incidence of disease progression at the end of the first year was recorded but was 20% at the end of 5 years, thereby resulting in a disease progression-free 5-year interval in 80% of our patients. Drug tolerance was excellent with a very low incidence of toxicity.