Koya Madhusudan P, Simon Michael A, Soloway Mark S
Department of Urology, University of Miami School of Medicine, Miami, Florida 33136, USA.
J Urol. 2006 Jun;175(6):2004-10. doi: 10.1016/S0022-5347(06)00264-3.
Intravesical therapy is an integral part of treatment in patients with superficial urothelial carcinoma of the bladder. The American Urological Association and European Association of Urology guidelines on bladder cancer incorporate it for the treatment of superficial bladder cancer. Given the extensive use of intravesical immunotherapy and chemotherapy, it is essential for the practicing urologist to be aware of the local and systemic side effects of these therapies.
We reviewed the literature on intravesical immunotherapy and chemotherapy with particular emphasis on side effects, complications and their management. A Medline search of the English language literature for the last 25 years was done on Entrez PubMed and all relevant articles were studied in full. All side effects and complications were studied and their management was reviewed.
Intravesical therapy for transitional cell carcinoma of the bladder is generally safe. There is a high incidence of local, usually self-limiting, relatively minor side effects and infrequent, potentially severe local and systemic side effects. Most side effects are avoidable.
Although intravesical therapy is generally safe, local and systemic side effects occur and it is important to be aware of them. Identifying complications early, preventing them when possible and managing them efficiently are critical. Most complications are preventable. Knowing the risks and benefits of chemotherapeutic and immunotherapeutic agents may decrease the short-term and long-term toxicity of these agents. Adherence to guidelines may prevent inappropriate use, which can lead to unnecessary complications, resulting in bladder dysfunction and even cystectomy.
膀胱内灌注治疗是浅表性膀胱尿路上皮癌患者治疗的一个重要组成部分。美国泌尿外科学会和欧洲泌尿外科学会的膀胱癌指南将其纳入浅表性膀胱癌的治疗。鉴于膀胱内免疫治疗和化疗的广泛应用，执业泌尿科医生了解这些治疗的局部和全身副作用至关重要。
我们回顾了关于膀胱内免疫治疗和化疗的文献，特别强调副作用、并发症及其管理。在Entrez PubMed上对过去25年的英文文献进行了Medline检索，并对所有相关文章进行了全面研究。对所有副作用和并发症进行了研究，并对其管理进行了回顾。
膀胱移行细胞癌的膀胱内灌注治疗一般是安全的。局部副作用发生率较高，通常为自限性，相对较轻，而潜在严重的局部和全身副作用较少见。大多数副作用是可以避免的。
虽然膀胱内灌注治疗一般是安全的，但会出现局部和全身副作用，了解这些副作用很重要。早期识别并发症、尽可能预防并有效管理并发症至关重要。大多数并发症是可以预防的。了解化疗和免疫治疗药物的风险和益处可能会降低这些药物的短期和长期毒性。遵循指南可防止不当使用，不当使用可能导致不必要的并发症，进而导致膀胱功能障碍甚至膀胱切除术。
