Meta Analysis Of The Efficacy And Safety Of Thermal Intravesical Chemotherapy In The Treatment Of Non-Muscular Invasive Bladder Cancer

Objective:to systematically evaluate the efficacy and safety of thermal intravesical chemotherapy and conventional instillation chemotherapy in the treatment of non-muscular invasive bladder cancer(NMIBC),and to systematically evaluate the efficacy of thermal intravesical chemotherapy and BCG immunotherapy in the treatment of NMIBC.Method:through searching PubMed,CochraneLibrary.com,Embase,Wanfang Med Online database,CNKI,VIP database,and CBM to collect clinical studies related to thermal intravesical chemotherapy in the treatment of NMIBC from 2000 to 2020.Referring to the manual of the Cochrane collaboration Network system evaluator,two evaluators independently screened,extracted and evaluated the methodological quality of the included literature according to the inclusion criteria and exclusion criteria,and then Meta analysis of the included literature was carried out by using RevMan5.3 software.Results:a total of 794 related articles were identified,and 19 articles were included after preliminary screening and re-screening,including 18 randomized controlled trials and 1 non-randomized controlled trials,including 1889 patients.Meta analysis showed that the recurrence-free survival rate(RFS)of thermal intravesical chemotherapy was higher than that of conventional infusion chemotherapy and conventional BCG infusion immunotherapy at the same time[RR=1.36,95%CI(1.24～1.48),P<0.00001)].Among them,thermal intravesical chemotherapy had obvious advantages compared with conventional instillation chemotherapy[RR=1.39,95%CI(1.26～1.53),PP<0.00001].There was no significant difference in 24-month relapse-free survival rate between the two groups compared with BCG(BCG)intravesical instillation immunotherapy[RR=1.04,95%CI(0.69～1.57),paired 0.84].The tumor progression-free survival rate(PFS)in the thermal intravesical chemotherapy group was higher than that in the conventional infusion chemotherapy group at the same time[RR=1.11,95%CI(1.06),P<0.0001),and the complications were similar in the two groups[RR=1.02,95%CI(0.83),0.83].Conclusion:thermal intravesical chemotherapy is an effective treatment for the prevention of NMIBC,and its curative effect is similar to that of BCG in inhibiting tumor recurrence,compared with conventional infusion chemotherapy.it has advantages in reducing tumor recurrence and delaying tumor progression without increasing complications.