Chatterjee Ambarish, Bakshi Ganesh, Pal Mahendra, Kapoor Akhil, Joshi Amit, Prakash Gagan
Department of Uro-Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Urol. 2021 Jul-Sep;37(3):226-233. doi: 10.4103/iju.IJU_540_20. Epub 2021 Jul 1.
Radical cystectomy with bilateral pelvic lymph node dissection is the standard of care for muscle invasive bladder cancer (MIBC). The role of neoadjuvant and adjuvant therapy has evolved over the last 3-4 decades, and neoadjuvant chemotherapy (NACT) has now become the standard recommended treatment. However, there are many nuances to this and the utilization of chemotherapy has not been universal. The optimum chemotherapy regimen is still debated. Adjuvant radiation has a role in high-risk patients although not established and immunotherapy has shown promising results. We reviewed the evidence on NACT and adjuvant chemotherapy (ACT) regimens, NACT versus ACT, and the role of adjuvant radiotherapy and immunotherapy in MIBC.
根治性膀胱切除术联合双侧盆腔淋巴结清扫术是肌层浸润性膀胱癌（MIBC）的标准治疗方法。在过去30 - 40年里，新辅助治疗和辅助治疗的作用不断演变，新辅助化疗（NACT）现已成为标准推荐治疗方法。然而，这其中存在许多细微差别，化疗的应用并不普遍。最佳化疗方案仍存在争议。辅助放疗在高危患者中具有一定作用，尽管尚未确立，且免疫治疗已显示出有前景的结果。我们回顾了关于NACT和辅助化疗（ACT）方案、NACT与ACT对比以及辅助放疗和免疫治疗在MIBC中作用的证据。
