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丝裂霉素C的电介导给药预防中高危患者经尿道膀胱肿瘤切除术后非肌层浸润性膀胱癌的复发和进展。

Electro-mediated drug administration of mitomycin C in preventing non-muscle-invasive bladder cancer recurrence and progression after transurethral resection of the bladder tumour in intermediate- and high-risk patients.

作者信息

Carando Roberto, Soldini Emiliano, Cotrufo Simone, Zazzara Michele, Ludovico Giuseppe M

机构信息

Klinik für Urologie, Luzerner Kantonsspital, Luzern, Switzerland.

Clinica Luganese Moncucco, Lugano, Switzerland.

出版信息

Arab J Urol. 2020 Aug 31;19(1):71-77. doi: 10.1080/2090598X.2020.1816150.

Abstract

OBJECTIVE

To evaluate the effectiveness of electro-mediated drug administration of mitomycin C (EMDA/MMC) after transurethral resection of the bladder tumour (TURBT) in preventing non-muscle-invasive bladder cancer (NMIBC) recurrence and progression and to explore clinical and demographic factors associated with treatment response.

PATIENTS AND METHODS

Between April 2016 and August 2019, 112 patients diagnosed with intermediate- or high-risk NMIBC underwent a TURBT followed by an EMDA/MMC treatment. The percentage of treatment responders and progression-free survivors at 3 and 6 months were evaluated.

RESULTS

Follow-up data were available for 101 patients (90%) at 3 months and 92 (82%) at 6 months. Response rates to EMDA/MMC treatment were 85% at 3 months and 75% at 6 months, and progression-free rates were 94% and 90%, respectively. No statistically significant differences were seen between intermediate- and high-risk patients. A higher risk of tumour recurrence and progression was associated with previous Bacillus Calmette-Guérin (BCG) failure. According to the Clavien-Dindo classification, only low-grade complications were observed.

CONCLUSIONS

EMDA/MMC after TURBT was associated with high response and progression-free rates at 3 and 6 months, with only low-grade adverse events. These results confirm the efficacy and safety of EMDA/MMC as a therapeutic option for both intermediate- and high-risk patients. However, patients with BCG failure responded poorly to EMDA/MMC.: ACCI: age-adjusted Charlson Comorbidity Index; CHT: chemohyperthermia; CIS: carcinoma ; EMDA: electro-mediated drug administration; EORTC: European Organisation for Research and Treatment of Cancer; IQR: interquartile range; (N)MIBC: (non-)muscle-invasive bladder cancer; MMC: mitomycin C; OR, odds ratio; TURBT: transurethral resection of the bladder tumour.

摘要

目的

评估经尿道膀胱肿瘤切除术(TURBT)后丝裂霉素C电介导药物给药(EMDA/MMC)预防非肌层浸润性膀胱癌(NMIBC)复发和进展的有效性,并探讨与治疗反应相关的临床和人口统计学因素。

患者与方法

2016年4月至2019年8月期间,112例诊断为中高危NMIBC的患者接受了TURBT,随后进行了EMDA/MMC治疗。评估了3个月和6个月时治疗反应者和无进展幸存者的百分比。

结果

3个月时101例患者(90%)、6个月时92例患者(82%)有随访数据。EMDA/MMC治疗的缓解率3个月时为85%,6个月时为75%,无进展率分别为94%和90%。中高危患者之间未见统计学显著差异。既往卡介苗(BCG)治疗失败与肿瘤复发和进展风险较高相关。根据Clavien-Dindo分类,仅观察到低级别并发症。

结论

TURBT后EMDA/MMC在3个月和6个月时具有高缓解率和无进展率,仅伴有低级别不良事件。这些结果证实了EMDA/MMC作为中高危患者治疗选择的有效性和安全性。然而,BCG治疗失败的患者对EMDA/MMC反应较差。:ACCI:年龄调整的Charlson合并症指数;CHT:化学热疗;CIS:癌;EMDA:电介导药物给药;EORTC:欧洲癌症研究与治疗组织;IQR:四分位间距;(N)MIBC:(非)肌层浸润性膀胱癌;MMC:丝裂霉素C;OR:比值比;TURBT:经尿道膀胱肿瘤切除术

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