Department of Urology, University of California Davis, 4860 Y Street, Suite 3500, Sacramento, CA 95817, USA.
Expert Rev Anticancer Ther. 2012 Jul;12(7):941-50. doi: 10.1586/era.12.60.
The current standard treatment for muscle-invasive nonmetastatic bladder cancer is neoadjuvant platinum-based chemotherapy followed by radical cystectomy. However, neoadjuvant chemotherapy is not widely accepted even with level 1 evidence. Adjuvant chemotherapy should be discussed if patients have not received neoadjuvant chemotherapy before surgery and have high-risk pathologic features. Although not considered standard of care, bladder-sparing therapy can be considered for highly selected patients and for those medically unfit for surgery. Even though there are no level 1 data, the treatment outcomes for highly select patients given bladder-sparing therapy appear promising, with many patients retaining a functional bladder. Personalized chemotherapy is currently being actively pursued to target the underlying molecular changes and tailor to individual needs.
目前，肌层浸润性非转移性膀胱癌的标准治疗方法是新辅助铂类化疗后行根治性膀胱切除术。然而，即使有 1 级证据，新辅助化疗也未被广泛接受。如果患者在术前未接受新辅助化疗且具有高危病理特征，则应讨论辅助化疗。尽管并非标准治疗方法，但对于高度选择的患者和因身体原因不适合手术的患者，可以考虑保留膀胱治疗。尽管没有 1 级数据，但对于接受保留膀胱治疗的高度选择患者，治疗结果似乎很有前景，许多患者保留了功能性膀胱。目前正在积极开展个体化化疗，以针对潜在的分子变化并满足个体需求。
