Colombo Renzo, van Valenberg Hans, Moschini Marco, Witjes Johannes A
Unit of Urology, Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan - Italy.
Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen - The Netherlands.
Urologia. 2016 Oct 4;83(Suppl 2):7-17. doi: 10.5301/uro.5000197. Epub 2016 Oct 1.
An updated review of intravesical radiofrequency (RF)-induced thermo-chemotherapy effect (RITE) for NMIBC with regard to efficacy, adverse events (AEs) and perspectives.
An extensive and sensitive search for RF-induced chemo-hyperthermia in Medline, Embase, Cochrane and ClinicalTrials.gov databases was performed. A table of published clinical trials up to 2016 was constructed. No meta-analysis could be performed on the basis of new papers.
Recurrence was seen 59% less after RITE than after mitomycin C (MMC) alone in adjuvant clinical setting with an overall bladder preservation rate after RITE of 85%. The efficacy was proved to be comparable to that of Bacillus Calmette-Guèrin (BCG), based on a single comparative multicentric study. Due to short follow-up, no conclusions can be drawn about time to recurrence and progression. The AE rate in RITE was higher, although not statistically significant, than MMC alone and similar to that of BCG, albeit different in the type of AE. In almost all studies, no severe AEs are reported.
RITE appears as a promising treatment option for NMIBC, particularly for high-risk patients with recurrent tumors, for those unsuitable for radical cystectomy and when Bacillus Calmette-Guèrin treatment is contraindicated. Further high-level evidence is needed for both reliable and reproducible data on efficacy and adverse events.
对非肌层浸润性膀胱癌（NMIBC）的膀胱内射频（RF）诱导热化疗效应（RITE）在疗效、不良事件（AE）及前景方面进行更新综述。
在Medline、Embase、Cochrane和ClinicalTrials.gov数据库中对RF诱导的化学热疗进行了广泛且敏感的检索。构建了截至2016年已发表临床试验的表格。无法基于新论文进行荟萃分析。
在辅助临床环境中，RITE后复发率比单独使用丝裂霉素C（MMC）低59%，RITE后的总体膀胱保留率为85%。基于一项单一的多中心比较研究，证明其疗效与卡介苗（BCG）相当。由于随访时间短，无法得出关于复发和进展时间的结论。RITE的AE发生率高于单独使用MMC，虽无统计学意义，且与BCG相似，尽管AE类型不同。在几乎所有研究中，均未报告严重AE。
RITE似乎是NMIBC的一种有前景的治疗选择，尤其适用于复发性肿瘤的高危患者、不适合根治性膀胱切除术的患者以及卡介苗治疗禁忌的患者。需要进一步的高级别证据以获得关于疗效和不良事件的可靠且可重复的数据。
