Impact of effective intravesical therapies on quality of life in patients with non-muscle invasive bladder cancer: a systematic review

John W. Yuen, Ricky W. Wu, Shirley S. Ching, Chi-Fai Ng

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Background: Conventional and newly emerged intravesical modalities have demonstrated prophylactic effectiveness that may improve quality of life (QoL) in non-muscle invasive bladder cancer. The purpose of this study is to analyze existing QoL evidence in patients receiving any form of intravesical therapy. Methods: A PubMed search without time restriction was conducted to identify all relevant studies in accordance with the PICOT question. Additionally, a search was also performed in the Cochrane library database, Internet, and citation. The CONSORT 2010 checklist and STROBE statement checklist were used to evaluate the risk of bias of the included studies. Results: A total of 24 eligible articles were included, which consisted of 11 interventional and 13 observational studies. Intravesical therapy with Bacillus Calmette–Guérin (BCG) or certain chemotherapeutic agents worsens symptom burdens and functional performance during the initial induction phase while continuous improved is observed throughout the maintenance treatment and beyond. Hyperthermia has shown a positive trend in enhancing QoL of patients receiving intravesical chemotherapy, which requires more investigations. However, QoL data were unavailable for other forms of immunotherapy, immune checkpoint inhibitors, electromotive drug administration, and photodynamic therapy. Conclusions: Limited studies suggested the long-term positive impact of intravesical BCG immunotherapy and chemotherapy. However, existing evidence was lacking to clarify the impact of many emerging intravesical therapies that have suggested to be effective and safe, which demands treatment-specific QoL studies.
Original languageEnglish
Article number10825
Number of pages24
JournalInternational Journal of Environmental Research and Public Health
Issue number17
Early online date30 Aug 2022
Publication statusPublished - Sep 2022


  • quality of life
  • health-related quality of life
  • non-muscle invasive bladder cancer
  • urothelial carcinoma
  • intravesical therapy
  • Bacillus Calmette–Guérin
  • chemotherapy
  • immunotherapy
  • hyperthermia
  • bladder cancer
  • humans
  • antineoplastic agents/therapeutic use
  • neoplasm recurrence, local
  • urinary bladder neoplasms/drug therapy
  • BCG vaccine/therapeutic use
  • administration, intravesical

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Pollution
  • Health, Toxicology and Mutagenesis


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