Hexaminolevulinate blue-light cystoscopy in non-muscle-invasive bladder cancer: review of the clinical evidence and consensus statement on appropriate use in the USA
Hexaminolevulinate blue-light cystoscopy in non-muscle-invasive bladder cancer: review of the clinical evidence and consensus statement on appropriate use in the USA
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DOI：
10.1038/nrurol.2014.245
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发表时间：
2014-10-01
影响因子：
15.3
通讯作者：
Steinberg, Gary D.
中科院分区：
文献类型：
--
作者：
Daneshmand, Siamak;Schuckman, Anne K.;Steinberg, Gary D.
HAL是一种肿瘤光敏剂，与蓝光膀胱镜检查（BLC）联合使用，作为白光膀胱镜检查（WLC）的辅助手段，用于诊断和治疗非肌层浸润性膀胱癌（NMIBC）。自2005年在欧洲获得许可以来，HAL已被用于> 200，000个程序，一致的证据表明，与单独的WLC相比，它提高了检测。目前的数据支持减少NMIBC复发的额外作用。自2010年FDA批准HAL以来，HAL-BLC在美国的经验不断扩大。为了确定需求领域并确定HAL-BLC在临床实践中的益处，专门从事膀胱癌患者管理的专家泌尿科医生组成的焦点小组召开会议，审查临床证据，分享他们的经验，并就HAL-BLC在美国的最佳使用达成共识。焦点小组得出结论，HAL-BLC应考虑用于NMIBC的初始评估、复发肿瘤的监测、尿细胞学检查阳性但WLC结果阴性的患者的诊断以及肿瘤分期。
Hexaminolevulinate (HAL) is a tumour photosensitizer that is used in combination with blue-light cystoscopy (BLC) as an adjunct to white-light cystoscopy (WLC) in the diagnosis and management of non-muscle-invasive bladder cancer (NMIBC). Since being licensed in Europe in 2005, HAL has been used in >200,000 procedures, with consistent evidence that it improves detection compared with WLC alone. Current data support an additional role in the reduction of recurrence of NMIBC. Since the approval of HAL by the FDA in 2010, experience of HAL-BLC in the USA continues to expand. To define areas of need and to identify the benefits of HAL-BLC in clinical practice, a focus group of expert urologists specializing in the management of patients with bladder cancer convened to review the clinical evidence, share their experiences and reach a consensus regarding the optimal use of HAL-BLC in the USA. The focus group concluded that HAL-BLC should be considered for initial assessment of NMIBC, surveillance for recurrent tumours, diagnosis in patients with positive urine cytology but negative WLC findings, and for tumour staging.