Sengeløv L, Kamby C, von der Maase H
Onkologisk afdeling, Københavns Amts Sygehus Herlev.
Ugeskr Laeger. 1993 May 3;155(18):1363-8.
This review reports the results of chemotherapy in advanced bladder cancer with emphasis on the latest studies concerning combination chemotherapy containing cisplatin and methotrexate. The main conclusion is, that chemotherapy has a tumor-reducing effect on both metastatic disease and local/regional recurrences, but it remains to be proven whether overall long-term survival is affected. Among patients who respond to chemotherapy, the survival seems to be prolonged, 10-15% of these patients achieving more than two years of disease-free survival. The most effective treatment regimes contain cisplatin and methotrexate. It is assumed that many patients with muscle-invasive bladder tumors have microscopic dissemination of the disease at the time of diagnosis, and chemotherapy has been given to these patients as primary treatment alone or as an adjuvant to cystectomy or radiotherapy. These studies have not been able to show any benefit in terms of prolonged survival of patients receiving chemotherapy. The results of on-going randomised studies are still awaited. It is concluded that chemotherapy to patients with both primary and metastatic bladder cancer is still an experimental treatment, which should only be used in the context of investigational studies.
本综述报告了晚期膀胱癌化疗的结果，重点是关于含顺铂和甲氨蝶呤联合化疗的最新研究。主要结论是，化疗对转移性疾病以及局部/区域复发均有肿瘤缩小作用，但化疗是否影响总体长期生存仍有待证实。在对化疗有反应的患者中，生存期似乎得以延长，其中10% - 15%的患者实现了两年以上的无病生存期。最有效的治疗方案包含顺铂和甲氨蝶呤。据推测，许多肌肉浸润性膀胱肿瘤患者在诊断时已有疾病的微观播散，化疗已被单独作为这些患者的初始治疗，或作为膀胱切除术或放疗的辅助治疗。这些研究未能显示接受化疗的患者在延长生存期方面有任何益处。仍在等待正在进行的随机研究结果。结论是，对原发性和转移性膀胱癌患者进行化疗仍是一种试验性治疗，仅应在研究性研究的背景下使用。
