Table 1.
Characteristics of the studies included in the meta-analysis.
| Reference | Study period | Study design | Samplesize | Clinical protocals | Number of patients | Age (yrs) | Median follow-up (month) | Tumor stage | Pathological grade |
Significantly differ between groups |
Previous intravesical treatment | Treatmentdevice | Treatmentschedule | Dose | Temperature (°C) | Duration (min) | Severity of AE | AE |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Zhao et al. (15) | 2011–2016 | Single-center RCT | 150 | BCG | 48 | 65.0 ± 7.1 | 24 | NR | NR | No | NR | LR-2005 external thermal field treatment system (Guangzhou Laiwei Medical Devices Co., Ltd. Guangzhou, China) |
BCG: 2 weeks after TURBT, BCG (150 mg) once a week for 6 weeks, then perfusion enhancement was performed at 3, 6, and 12 months, respectively. ETFT-MMC: 1 week after TURBT, MMC (30 mg) perfusion associated with ETFT once a week for 8 weeks, then once a month for 12 months. MMC: 1 week after TURBT, MMC (30 mg) once a week for 8 weeks, then once a month for 12 months. |
– | NT | NR | Mild | Two influenza-like symptoms |
| ETFT-MMC | 49 | 67.0 ± 5.2 | 24 | 30 mg/30 ml | 41~43 | 60 | Three lower abdomen skin redness | |||||||||||
| MMC | 48 | 66.0 ± 5.4 | 24 | 30 mg/30 ml | NT | NR | 0 | |||||||||||
| Colombo et al. (16) | 1994–1999 | Multicentre RCT | 83 | ETFT-MMC | 39 | ≤95:>65 = 25:17 | 24.0 | Ta:T1:CIS = 15:26;1 | G1:G2:G3 = 4:27:11 | No | Having not received either local or systemic chemotherapy or radiotherapy during the last 3 months. | Synergo101–1 (Medical Enterprises, Amsterdam, the Netherlands) |
ETFT-MMC: 20–40 days after TURBT, an induction cycle of 8 weekly sessions and a subsequent maintenance regimen of 4 monthly sessions. MMC: 20–40 days after TURBT, an induction cycle of 8 weekly sessions and a subsequent maintenance regimen of 4 monthly sessions. |
20 mg/50 ml | 40~44 | 40~60 | Various | Thirty-four have different side effects of different severity |
| MMC | 36 | ≤65:>65 = 16:25 | 24.0 | Ta:T1 = 17:24 | G1:G2:G3 = 1:33:7 | 20 mg/50 ml | NT | 60 | Twenty-one have different side effects of different severity | |||||||||
| Gao et al. (17) | 2009–2012 | Single-center RCT | 64 | HIVEC-MMC | 32 | 54.9 ± 8.1 | 36.0 | T1 | G1:G2 = 16:16 | No | NR | NR |
HIVEC-MMC: 1 week after TURBT, MMC (30mg) once a week for 6 weeks, then every 2 weeks for six rounds. MMC: 1week after TURBT, MMC (30mg) once a week for 6 weeks, then every 2 weeks for six rounds. |
30 mg/500 ml | 42~43 | 120 | Mild | Six bladder irritation |
| MMC | 32 | 56.5 ± 5.6 | 36.0 | G1:G2 = 14:18 | 30 mg/500 ml | NT | NR | Seven bladder irritation | ||||||||||
| Guo et al. (18) | 2013–2015 | Single-center RCT | 84 | HIVEC-GEM | 42 | 77.0 ± 6.0 | 24.0 | Tis:TaG1/G2:G3:T1 = 3:20:11:8 | No | NR | NR | HIVEC-GEM: Within 6 h after TURBT, GEM (1,000 mg) hyperthermic perfusion, then once a week for 8 weeks, after that every months for 1 year.GEM: Within 6 h after TURBT, GEM (1,000 mg) normal temperature perfusion, then once a week for 8 weeks, after that every months for 1 year. | 1,000 mg/500 ml | 42~44 | 120 | Mild | Two hematuria and three urinary pain and four cystitis and three anorexia and three anxiety and two insomnia and one rash | |
| GEM | 42 | 76.0 ± 7.0 | 24.0 | Tis:TaG1/G2:G3:T1 = 4:20:12:6 | NR | NT | NR | Eight hematuria and 10 urinary pain and 11 cystitis and 4 anorexia and 3 anxiety and 3 insomnia and 1 rash | ||||||||||
| Guo et al. (19) | 2014–2016 | Single-center RCT | 74 | HIVEC-THP | 38 | 75.9 ± 5.7 | 24.0 | Ta:T1 = 20:18 | G1:G2 = 23:15 | No | NR | NR |
HIVEC-THP: Within 6 h after TURBT, THP (40 mg) hyperthermic perfusion, then once a week for 8 weeks, after that every months for 1 year. THP: 1 week after TURBT, THP (40 mg) normal temperature perfusion, then once a week for 8 weeks, after that every months for 1 year. |
40 mg/45 ml | 42~44 | NR | Mild | Repeated calculation |
| THP | 36 | 75.0 ± 5.8 | 24.0 | Ta:T1 = 19:17 | G1:G2 = 24:12 | 40 mg/45 ml | NT | NR | ||||||||||
| Li et al. (20) | 2011–2014 | Single-center RCT | 90 | HIVEC-MMC | 45 | 58.4 ± 10.2 | NR | T1 | G1:G2 = 16:29 | No | NR | BR-TRG-I type high-precision hyperthermic intraperitoneal perfusion treatment system |
HIVEC-MMC: 3 days after TURBT, MMC (80 mg) hyperthermic perfusion, three times a day for four rounds. MMC: Within 24 h after TURBT, MMC normal temperature perfusion, then every 3 days for four rounds. |
80 mg/600 ml | 43 | 45 | Mild | Ten bladder irritation |
| MMC | 45 | 60.4 ± 10.2 | NR | G1:G2 = 14:31 | NR | NT | 45 | Seven bladder irritation and one myelosuppression and one abnormal blood biochemical indexes | ||||||||||
| Liu et al. (21) | 2009–2011 | Single-center RCT | 56 | ETFT-THP | 27 | 48.0~84.0 | 24.0 | NR | low grade: high grade = 34:22 | NR | No | ZD-2001 external thermal field treatment system |
ETFT-THP: after TURBT, THP (40 mg) perfusion associated with ETFT once a week for 6 weeks, then THP (40 mg) only once every 2 weeks for 6 rounds, after that every months for six months. THP: after TURBT, THP (40 mg) once a week for 6 weeks, then once every 2 weeks for six rounds, after that every months for 6 months. |
40 mg/40 ml | 41~43 | 60 | Mild | Five LUTS and two abnormal blood biochemical indexes |
| THP | 29 | 24.0 | 40 mg/40 ml | NT | 30 | 13 LUTS and one abnormal blood biochemical indexes | ||||||||||||
| Liu et al. (22) | 2011–2014 | Single-center RCT | 40 | HIVEC-MMC | 20 | 51.5 ± 20.2 | 36.0 | T1 | G1:G2 = 18:22 | No | NR | NR |
HIVEC-MMC: 1 week after TURBT, MMC (30 mg) hyperthermic perfusion once a week for 6 weeks, then once every 2 weeks for six rounds. MMC: 1 week after TURBT, MMC (30 mg) once a week for 6 weeks, then once every 2 weeks for six rounds. |
30 mg/500 ml | 42~43 | 120 | Mild | Four hematuria and 10 bladder irritation |
| MMC | 20 | 36.0 | 30 mg/500 ml | NT | NR | Two hematuria and eight bladder irritation | ||||||||||||
| Peng et al. (23) | 2010–2012 | Single-center RCT | 86 | HIVEC-THP | 44 | 42.0~68.0 | 22.3 | Ta:T1 = 24:20 | G1:G2 = 23:21 | No | No | BR-TRG-I type high-precision hyperthermic intraperitoneal perfusion treatment system |
HIVEC-THP: 1 week after TURBT, THP (40 mg) hyperthermia perfusion once a week for 8 weeks, after that every months for 8 months. THP: 1 week after TURBT, THP (40 mg) once a week for 8 weeks, after that every months for 8 months. |
40 mg/600 ml | 45 | 60 | Mild | One gross hematuria |
| THP | 42 | 22.3 | Ta:T1 = 23:19 | G1:G2 = 10:32 | 40 mg/50 ml | NT | 60 | 0 | ||||||||||
| Su et al. (24) | 2012–2014 | Single-center RCT | 76 | HIVEC-MMC | 38 | 50.2 ± 7.3 | 36.0 | NR | NR | No | NR | NR |
HIVEC-MMC: After TURBT, MMC (30 mg) hyperthermic perfusion once a week for 6 weeks, then twice a month for six rounds. MMC: After TURBT, MMC (30 mg) once a week for 6 weeks, then twice a month for six rounds. |
30 mg/300 ml | 45 | 120 | Mild | One bladder irritation and one urinary tract infection |
| MMC | 38 | 50.5 ± 7.6 | 36.0 | 30 mg/500 ml | NT | NR | Four bladder irritation and four urinary tract infection and three fatigue | |||||||||||
| Zhao et al. (25) | 2009–2014 | Single-center RCT | 83 | ETFT-HCPT | 39 | 65.0 ± 7.1 | 24.0 | Ta:T1 = 15:27 | G1:G2:G3 = 4:27:11 | No | NR | LR-2005 external thermal field treatment system (Guangzhou Laiwei Medical Devices Co., Ltd. Guangzhou, China) |
ETFT-HCPT: Within 24 h after TURBT, HCPT (20 mg) perfusion associated with ETFT, then once a week for 8 weeks, after that once a month for 6 months. HCPT: Within 24 h after TURBT, HCPT (20 mg) perfusion only, then once a week for 8 weeks, after that once a month for 6 months. |
20 mg/40 ml | 41~43 | 60 | Mild | Repeated calculation |
| HCPT | 37 | 67.0 ± 5.2 | 24.0 | Ta:T1 = 17:24 | G1:G2:G3 = 1:33:7 | 20 mg/40 ml | NT | 60 | ||||||||||
| Wang et al. (26) | 2010–2015 | Single-center Retrospective | 74 | HIVEC-THP | 37 | 62.2 ± 7.4 | 24.0 | Ta:T1 = 19:18 | low grade: high grade = 27:10 | No | No | BR-TRG-I type high-precision hyperthermic intraperitoneal perfusion treatment system |
HIVEC-THP: Within 24 h after TURBT, THP (30 mg) hyperthermic perfusion, then once a week for 8 weeks, after that once a month. THP: Within 24 h after TURBT, THP (30 mg) perfusion, then once a week for 8 weeks, after that once a month. |
30 mg/1,500 ml | 43 | 60 | Mild | Five bladder irritation |
| THP | 37 | 61.5 ± 7.2 | 24.0 | Ta:T1 = 21:16 | low grade: high grade = 29:8 | 30 mg/50 ml | NT | 60 | Two bladder irritation | |||||||||
RCT, randomized controlled trial; ETFT, external thermal field thermotherapy; HIVEC, hyperthermic intravesical chemotherapy; MMC, mitomycin C; THP, pirarubicin; GEM, gemcitabine; HCPT, hydroxycamptothecine; NT, normal temperature; NR, not report.