为了评估膀胱内化疗替代对中高危非肌层侵袭性膀胱癌（NMIBC）患者的疗效，这些患者接受了卡介苗（BCG）灌注但由于全球短缺或BCG的毒性中止了治疗。这项回顾性研究包括接受BCG膀胱内灌注的中高风险NMIBC患者。那些中止治疗的人被分为单纯BCG组和化疗替代组。对这些组进行了比较。主要终点是膀胱复发无生存期（RFS）。共纳入480名患者。基线特征在组间相似，但化疗替代组的总灌注次数高于单纯BCG组（n = 14.9对10.5）。化疗替代组在三年RFS方面表现更好（p = 0.022）。多元分析表明，与化疗替代组相比，单纯BCG组的全年和3年复发率显著增加（危害比为2.015和2.148）。在接受BCG灌注但面临停止治疗的中高危NMIBC患者中，化疗替代比不进行灌注有更好的三年RFS。

To evaluate the efficacy of intravesical chemotherapy replacement in patients with intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC), who underwent bacillus Calmette-Guérin (BCG) instillation but discontinued due to global shortages or toxicity of BCG.This retrospective study included patients with intermediate- and high-risk NMIBC who received BCG intravesical instillation. Those who discontinued the treatment were divided into the pure BCG group and chemotherapy replacement group. Comparisons between these groups were performed. The primary endpoint was bladder recurrence-free survival (RFS).A total of 480 patients were included. Baseline characteristics were similar between groups, but the total instillation times were higher in the chemotherapy replacement group than in the pure BCG group (n = 14.9 vs. 10.5). The chemotherapy replacement group had a better three-year RFS (p = 0.022). On multivariate analysis, the pure BCG group had significantly increased all-time and 3-year recurrences (hazard ratio 2.015 and 2.148) compared to the chemotherapy replacement group.Chemotherapy replacement has a better three-year RFS than no instillation in patients with intermediate- and high-risk NMIBC who received BCG instillation but facing treatment stoppage.