The Efficacy of Trimodal Chemoradiotherapy with Cisplatin as a Bladder-Preserving Strategy for the Treatment of Muscle-Invasive Bladder Cancer
The Efficacy of Trimodal Chemoradiotherapy with Cisplatin as a Bladder-Preserving Strategy for the Treatment of Muscle-Invasive Bladder Cancer
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DOI：
10.1159/000477912
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发表时间：
2017-01-01
影响因子：
1.6
通讯作者：
Matsuyama, Hideyasu
中科院分区：
文献类型：
--
作者：
Nagao, Kazuhiro;Hara, Takahiko;Matsuyama, Hideyasu
简介：开放性根治性膀胱癌（ORC）目前是无转移的肌层浸润性膀胱癌（MIBC）的标准治疗方法，而许多MIBC患者由于多种合并症并不总是合适的候选人。为了评估膀胱保存策略，我们将结果与ORC获得的结果进行了比较。患者和方法：我们回顾性分析了50例MIBC患者接受顺铂三联放化疗（CDDP-放疗[CDDP-R]）治疗的数据。在治疗前进行经尿道膀胱肿瘤切除术（TURBT），以确认病理分期>= T2。在放化疗后进行广泛的TURBT，以评估对治疗的病理反应。我们通过倾向评分匹配分析比较了我们的CDDP-R与ORC（回顾性队列，n = 205）的生存结局。结果如下：治疗后2年和5年无进展生存率、膀胱完整生存率、癌症特异性生存率和总生存率（OS）分别为70.8%和63.9%、64.0%和49.8%、86.7%和71.8%、84.3%和64.8%。CDDP-R治疗后的2年和5年OS率分别为90.5%和74.3%，ORC治疗后的2年和5年OS率分别为71.8%和59.9%，这表明CDDP-R相对于ORC具有显著的生存优势（p < 0.05，HR 0.45，95% CI 0.210.94）。结论：在选定的患者中，CDDP-R用于MIBC可能提供与ORC相当的肿瘤学结局。(C)2017 S. Karger AG，巴塞尔
Introduction: Open radical cystectomy (ORC) is currently the standard treatment for muscle-invasive bladder cancer (MIBC) without metastasis, while many patients with MIBC are not always appropriate candidates due to multiple comorbidities. To evaluate the bladder-preservation strategy, we compared the results with those obtained by ORC. Patients and Methods: We retrospectively analyzed the data of 50 patients with MIBC treated by trimodal chemoradiotherapy with cisplatin (CDDP-radiation [CDDP-R]). Transurethral resection of the bladder tumor (TURBT) was performed before treatment to confirm pathological stage >= T2. Extensive TURBT was performed after chemoradiotherapy to evaluate the pathological response to treatment. We compared the survival outcomes of our CDDP-R with those of ORC (retrospective cohort, n = 205) by propensity score matching analysis. Results: The 2-and 5-year progression-free survival, bladder-intact survival, cancer-specific survival, and overall survival (OS) rates after treatment were 70.8 and 63.9%, 64.0 and 49.8%, 86.7 and 71.8%, and 84.3 and 64.8%, respectively. The 2-and 5-year OS rates after CDDP-R were 90.5 and 74.3%, respectively, and those after ORC were 71.8 and 59.9%, respectively, indicating a significant survival advantage conferred by CDDP-R over ORC (p < 0.05, HR 0.45, 95% CI 0.210.94). Conclusions: In selected patients, CDDP-R for MIBC may provide comparative oncological outcomes as ORC. (C) 2017 S. Karger AG, Basel