Department of Radiation Oncology, James Cancer Hospital, The Ohio State University, 460 West 10th Avenue, 2nd Floor, Columbus, OH 43210, USA.
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Cox 3, Boston, MA 02114, USA.
Hematol Oncol Clin North Am. 2021 Jun;35(3):567-584. doi: 10.1016/j.hoc.2021.02.006. Epub 2021 Apr 15.
Bladder-preserving trimodality therapy (TMT), consisting of trans-urethral bladder tumor resection followed by concurrent chemoradiotherapy, is an established standard of care for patients with muscle-invasive bladder cancer. For appropriately selected patients, TMT offers oncologic outcomes comparable to radical cystectomy while preserving the patient's native bladder. Optimal TMT outcomes require careful patient selection, which is currently based on clinical and pathologic factors. The role of immune checkpoint blockade (ICB) in TMT is currently being investigated in several on-going clinical trials. In the future, molecular features associated with response to TMT or ICB may further improve patient selection and guide post-treatment surveillance.
膀胱保留的三联疗法（TMT），包括经尿道膀胱肿瘤切除术，然后进行同期放化疗，是肌层浸润性膀胱癌患者的标准治疗方法。对于选择合适的患者，TMT 提供了与根治性膀胱切除术相当的肿瘤学结果，同时保留了患者的原生膀胱。最佳 TMT 结果需要仔细的患者选择，目前基于临床和病理因素。免疫检查点阻断（ICB）在 TMT 中的作用目前正在几项正在进行的临床试验中进行研究。未来，与 TMT 或 ICB 反应相关的分子特征可能会进一步改善患者选择并指导治疗后监测。
