Division of Urology, Duke University Medical Center, Box 2812, Durham, NC 27710, USA.
Biomed Res Int. 2013;2013:262313. doi: 10.1155/2013/262313. Epub 2013 Sep 1.
Nonmuscle invasive bladder cancer remains a very costly cancer to manage because of high recurrence rates requiring long-term surveillance and treatment. Emerging evidence suggests that adjunct and concurrent use of hyperthermia with intravesical chemotherapy after transurethral resection of bladder tumor further reduces recurrence risk and progression to advanced disease. Hyperthermia has both direct and immune-mediated cytotoxic effect on tumor cells including tumor growth arrest and activation of antitumor immune system cells and pathways. Concurrent heat application also acts as a sensitizer to intravesical chemotherapy agents. As such the ability to deliver hyperthermia to the focus of tumor while minimizing damage to surrounding benign tissue is of utmost importance to optimize the benefit of hyperthermia treatment. Existing chemohyperthermia devices that allow for more localized heat delivery continue to pave the way in this effort. Current investigational methods involving heat-activated drug delivery selectively to tumor cells using temperature-sensitive liposomes also offer promising ways to improve chemohyperthermia efficacy in bladder cancer while minimizing toxicity to benign tissue. This will hopefully allow more widespread use of chemohyperthermia to all bladder cancer patients, including metastatic bladder cancer.
非肌肉浸润性膀胱癌由于复发率高，需要长期监测和治疗，因此仍然是一种非常昂贵的癌症。新出现的证据表明，在经尿道膀胱肿瘤切除术之后，辅助和同时使用热疗与膀胱内化疗可以进一步降低复发风险和进展为晚期疾病的风险。热疗对肿瘤细胞具有直接和免疫介导的细胞毒性作用，包括肿瘤生长停滞和激活抗肿瘤免疫系统细胞和途径。同时应用热量也可作为膀胱内化疗药物的增敏剂。因此，将热疗输送到肿瘤焦点，同时最大限度地减少对周围良性组织的损伤，对于优化热疗治疗的益处至关重要。允许更局部热传递的现有化学热疗设备在这方面继续发挥作用。目前涉及使用温度敏感脂质体将热激活药物选择性递送到肿瘤细胞的研究方法也为提高膀胱癌的化学热疗效果并最小化对良性组织的毒性提供了有希望的方法。这有望使更多的膀胱癌患者，包括转移性膀胱癌患者，能够更广泛地使用化学热疗。
