Jiang Di Maria, Chung Peter, Kulkarni Girish S, Sridhar Srikala S
Department of Medicine, Division of Medical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Canada, 700 University Avenue, Toronto, ON, Canada.
Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Cancer Center, University Health Network, University of Toronto, Canada, 700 University Ave, Toronto, ON, Canada.
Curr Oncol Rep. 2020 Feb 1;22(2):14. doi: 10.1007/s11912-020-0880-5.
Bladder-sparing trimodality therapy (TMT) has become an accepted alternative to cystectomy for selected muscle invasive bladder cancer (MIBC) patients unfit for cystectomy or opting for bladder preservation. This review will summarize recent advances in TMT for MIBC.
A growing body of literature has emerged which supports the use of TMT. However, its delivery is yet to be standardized. The role of chemotherapy and predictive biomarkers remain to be elucidated. Novel bladder-sparing approaches, drug combinations including immunotherapy and targeted therapies are under investigation in clinical trials, with the goal of ultimately enhancing survival and quality of life outcomes. Recent advances in TMT have made bladder preservation possible for MIBC patients seeking an alternative local therapy to cystectomy. With careful patient selection, TMT offers comparable survival outcomes to cystectomy, and improved quality of life as patients are able to successfully retain their bladder.
对于部分不适合行膀胱切除术或选择保留膀胱的肌层浸润性膀胱癌（MIBC）患者，保留膀胱的三联疗法（TMT）已成为膀胱切除术可接受的替代方案。本综述将总结MIBC的TMT的最新进展。
越来越多的文献支持使用TMT。然而，其实施尚未标准化。化疗和预测生物标志物的作用仍有待阐明。新型保留膀胱方法、包括免疫疗法和靶向疗法在内的联合用药正在临床试验中进行研究，最终目标是提高生存率和生活质量。TMT的最新进展使寻求替代膀胱切除术的局部治疗的MIBC患者能够保留膀胱。通过仔细选择患者，TMT可提供与膀胱切除术相当的生存结果，并提高生活质量，因为患者能够成功保留膀胱。
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