Li Haitao, Long Gongwei, Tian Jun
Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Front Oncol. 2023 Oct 4;13:1255632. doi: 10.3389/fonc.2023.1255632. eCollection 2023.
Photodynamic therapy (PDT) is a promising treatment for non-muscle-invasive bladder cancer (NMIBC), we conducted this systematic review to comprehensively assess its efficacy and safety.
A comprehensive literature research was conducted using PubMed, Web of Science, and Scopus, and studies reporting the safety and efficacy of PDT in NMIBC were included. Complete response (CR) rates, recurrence-free survival (RFS) at different time points, and complication incidences were extracted and synthesized. Pooled results were presented as rates with a 95% confidence interval (95% CI).
Overall, 28 single arm studies were included in the meta-analysis. For unresectable NMIBC, therapeutic PDT achieved CR in 68% (95% CI: 59%-77%) of patients. Among these CR cases, 71% (95% CI: 56%-85%) and 38% (95% CI: 12%-64%) have a RFS longer than 12 and 24 months, respectively. For Tis patients, the CR rate was 68% (95% CI: 56%-80%), and 84% (95% CI: 48%-100%) and 13% (95% CI: 1%-32%) have a RFS longer than 12 and 24 months. For patients with resectable tumors, post-resection adjuvant PDT could provide a 12 and 24 months RFS in 81% (95% CI:76%-87%) and 56% (95% CI:41%-71%) of them. Especially, for NMIBC patients who failed BCG therapy, adjuvant PDT could still achieve a 1-year and 2-year RFS in 68% (95% CI:51%-86%) and 56% (95% CI:32%-81%) patients. The complications were mostly mild and transient, including lower urinary tract symptoms and photosensitivity.
Both therapeutic and adjuvant PDT present satisfying safety and efficacy for NMIBC, including these cases that are resistant to the standard of care. As a promising option for NMIBC, PDT deserves further exploration by future high-quality research.
https://inplasy.com/inplasy-2022-11-0043/, INPLASY2022110043.
光动力疗法（PDT）是一种治疗非肌层浸润性膀胱癌（NMIBC）的有前景的方法，我们进行了这项系统评价以全面评估其疗效和安全性。
使用PubMed、Web of Science和Scopus进行全面的文献检索，并纳入报告PDT治疗NMIBC安全性和疗效的研究。提取并综合完全缓解（CR）率、不同时间点的无复发生存率（RFS）和并发症发生率。汇总结果以率和95%置信区间（95%CI）表示。
总体而言，荟萃分析纳入了28项单臂研究。对于无法切除的NMIBC，治疗性PDT使68%（95%CI：59%-77%）的患者达到CR。在这些CR病例中，分别有71%（95%CI：56%-85%）和38%（95%CI：12%-64%）的患者无复发生存期超过12个月和24个月。对于Tis患者，CR率为68%（95%CI：56%-80%），分别有84%（95%CI：48%-100%）和13%（95%CI：1%-32%）的患者无复发生存期超过12个月和24个月。对于可切除肿瘤的患者，切除术后辅助性PDT可使81%（95%CI：76%-87%）和56%（95%CI：41%-71%）的患者获得12个月和24个月的无复发生存期。特别是，对于卡介苗（BCG）治疗失败的NMIBC患者，辅助性PDT仍可使68%（95%CI：51%-86%）和56%（95%CI：32%-81%）的患者获得1年和2年的无复发生存期。并发症大多为轻度且短暂，包括下尿路症状和光敏反应。
治疗性和辅助性PDT对NMIBC均显示出令人满意的安全性和疗效，包括对标准治疗耐药的病例。作为NMIBC的一种有前景的选择，PDT值得未来高质量研究进一步探索。
https://inplasy.com/inplasy-2022-11-0043/，INPLASY2022110043。
