Bamias Aristotle, Dimopoulos Meletios A
Department of Clinical Therapeutics, Medical School, University of Athens, Haidari, 124 62 Athens, Greece.
Expert Rev Anticancer Ther. 2005 Dec;5(6):993-1000. doi: 10.1586/14737140.5.6.993.
The role of neoadjuvant chemotherapy in muscle-invasive bladder cancer has been clarified by recent randomized studies and meta-analyses, which all showed that cisplatin-based, combination chemotherapy offers a significant survival advantage. Preoperative chemotherapy results in downstaging in a significant percentage of patients, which is an independent factor of favorable prognosis. Nevertheless, the optimal sequence of perioperative chemotherapy remains undefined. The authors examine the results of large Phase II and randomized studies as well as the role of neoadjuvant chemotherapy in the context of bladder preservation strategies. Finally, issues of improving therapeutic efficacy and directing clinical research are discussed.
新辅助化疗在肌层浸润性膀胱癌中的作用已通过近期的随机研究和荟萃分析得以阐明，这些研究均表明，基于顺铂的联合化疗可带来显著的生存优势。术前化疗可使相当比例的患者分期降低，这是预后良好的独立因素。然而，围手术期化疗的最佳顺序仍不明确。作者研究了大型II期和随机研究的结果以及新辅助化疗在膀胱保留策略背景下的作用。最后，讨论了提高治疗效果和指导临床研究的问题。
