Department of Radiation Oncology, Institut du cancer de Montpellier, Fédération universitaire d'oncologie radiothérapie de Méditerranée Occitanie, université de Montpellier, Inserm U1194, Montpellier, France.
Hôpital Saint-Louis, Paris, France.
Cancer Radiother. 2024 Nov;28(6-7):623-627. doi: 10.1016/j.canrad.2024.08.005. Epub 2024 Oct 9.
Trimodal therapy consisting of transurethral resection of bladder tumors followed by radiotherapy and chemotherapy, has emerged as a valuable therapeutic alternative to radical cystectomy in patients with muscle invasive bladder cancer. Concomitant radiosensitising chemotherapy is a component of trimodality increasing locoregional control compared to radiotherapy alone. The combinations 5-fluorouracil with mitomycin or cisplatin are the best supported in the literature. Gemcitabine appears to be a feasible and promising alternative. There is considerable international heterogeneity in terms of dose, volumes and fractionation. The most commonly used regimens are moderately hypofractionated (55Gy in 20 fractions over 4 weeks) and normofractionated (64Gy in 32 fractions) regimens. Radiotherapy for bladder cancer is an effective and evolving treatment, with current technical developments, and studies of new combinations with systemic treatments underway.
包括经尿道膀胱肿瘤切除术加放疗和化疗的三联疗法，已经成为肌层浸润性膀胱癌患者除根治性膀胱切除术以外的一种有价值的治疗选择。同时进行放疗增敏化疗是三联疗法的一个组成部分，与单纯放疗相比，可提高局部区域控制率。5-氟尿嘧啶联合丝裂霉素或顺铂是文献中支持最好的联合用药。吉西他滨似乎是一种可行且有前途的替代药物。在剂量、体积和分割方面存在相当大的国际异质性。最常用的方案是中度适形放疗（55Gy，20 次，4 周）和常规适形放疗（64Gy，32 次）。膀胱癌的放疗是一种有效的治疗方法，随着当前技术的发展，以及正在进行的与全身治疗联合的新组合研究，其疗效也在不断提高。
