卡介苗治疗失败及其他情况：非肌层浸润性膀胱癌的当代管理
Bacillus calmette-guérin failures and beyond: contemporary management of non-muscle-invasive bladder cancer.
作者信息
Grossman H Barton, O'Donnell Michael A, Cookson Michael S, Greenberg Richard E, Keane Thomas E
出版信息
Rev Urol. 2008 Fall;10(4):281-9.
Abstract
In the United States, bacillus Calmette-Guérin (BCG) is the treatment most used for superficial bladder cancer. Patients with carcinoma in situ (CIS) treated with intravesical BCG plus interferon have a 60% to 70% chance of a complete and durable response if they were never treated with BCG or if they failed only 1 prior induction or relapsed more than a year from induction. Intravesical gemcitabine is safe, but its usefulness for BCG-refractory patients is unclear. Valrubicin, approved for intravesical treatment of BCG-refractory CIS of the bladder, has efficacy and acceptable toxicity. Cystectomy should be considered in high-risk, non-muscle-invasive cancer, particularly if intravesical therapy failed.
摘要
在美国，卡介苗（BCG）是治疗浅表性膀胱癌最常用的方法。原位癌（CIS）患者若从未接受过卡介苗治疗，或仅在1次诱导治疗失败后，或在诱导治疗1年多后复发，接受膀胱内卡介苗加干扰素治疗有60%至70%的机会获得完全且持久的缓解。膀胱内吉西他滨是安全的，但其对卡介苗难治性患者的有效性尚不清楚。已批准用于膀胱内治疗卡介苗难治性膀胱原位癌的瓦鲁比星具有疗效且毒性可接受。对于高危非肌层浸润性癌，尤其是膀胱内治疗失败的情况，应考虑行膀胱切除术。
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