China-Japan Union Hospital of Jilin University, Jilin University, Changchun 130033, China.
Nanozyme Medical Center, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China.
J Mater Chem B. 2024 Mar 20;12(12):2938-2949. doi: 10.1039/d3tb02837b.
The standard treatment for non-muscle invasive bladder cancer (NMIBC) is transurethral resection of bladder tumor (TURBT). However, this procedure may miss small lesions or incompletely remove them, resulting in cancer recurrence or progression. As a result, intravesical instillation of chemotherapy or immunotherapy drugs is often used as an adjunctive treatment after TURBT to prevent cancer recurrence. In the traditional method, drugs are instilled into the patient's bladder through a urinary catheter under sterile conditions. However, this treatment exposes the bladder mucosa to the drug directly, leading to potential side effects like chemical cystitis. Furthermore, this treatment has several limitations, including a short drug retention period, susceptibility to urine dilution, low drug permeability, lack of targeted effect, and limited long-term clinical efficacy. Hydrogel, a polymer material with a high-water content, possesses solid elasticity and liquid fluidity, making it compatible with tissues and environmentally friendly. It exhibits great potential in various applications. One emerging use of hydrogels is in intravesical instillation. By employing hydrogels, drug dilution is minimized, and drug absorption, retention, and persistence in the bladder are enhanced due to the mucus-adhesive and flotation properties of hydrogel materials. Furthermore, hydrogels can improve drug permeability and offer targeting capabilities. This article critically examines the current applications and future prospects of hydrogels in the treatment of bladder cancer.
标准治疗非肌肉浸润性膀胱癌(NMIBC)是经尿道膀胱肿瘤切除术(TURBT)。然而,该手术可能会遗漏小病变或不能完全切除它们,导致癌症复发或进展。因此,TURBT 后常采用膀胱内灌注化疗或免疫治疗药物作为辅助治疗,以预防癌症复发。在传统方法中,药物通过无菌条件下的导尿管注入患者的膀胱。然而,这种治疗方法直接将膀胱黏膜暴露于药物中,导致潜在的副作用,如化学性膀胱炎。此外,这种治疗方法存在几个局限性,包括药物保留期短、易受尿液稀释、药物渗透性低、缺乏靶向作用和长期临床疗效有限。水凝胶是一种高含水量的聚合物材料,具有固体弹性和液体流动性,与组织相容性好,对环境友好。它在各种应用中具有很大的潜力。水凝胶的一个新兴用途是在膀胱内灌注。通过使用水凝胶,可以减少药物稀释,并且由于水凝胶材料的粘液附着和漂浮特性,增强了药物在膀胱中的吸收、保留和持久性。此外,水凝胶可以提高药物的渗透性并提供靶向能力。本文批判性地审查了水凝胶在膀胱癌治疗中的当前应用和未来前景。