Vitale V
Servizio di Oncologia Radioterapica, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Rays. 1997 Jul-Sep;22(3):406-9.
Optimal management of bladder cancer is still controversial. With radiotherapy organ preservation is achieved in 30% of patients in the absence of unfavorable factors. Better results are achieved with accelerated fractionation, neoadjuvant chemotherapy or concomitant radiochemotherapy. In particular, with the latter, the rate of complete response (70%) is 30% higher as compared to radiotherapy alone or transurethral resection (TUR) of bladder and chemotherapy. In the treatment of intracapsular prostate cancer, radiotherapy is a valid alternative to prostatectomy with comparable results in terms of disease-free survival. In case of extraprostatic disease, results are clearly less satisfactory because of lower local control and blood-borne metastases. Conformal radiotherapy and neoadjuvant and adjuvant hormonotherapy are being studied to improve results.
膀胱癌的最佳治疗方案仍存在争议。在没有不利因素的情况下，放疗可使30%的患者实现器官保留。加速分割放疗、新辅助化疗或同步放化疗能取得更好的效果。特别是同步放化疗，其完全缓解率（70%）比单纯放疗或经尿道膀胱肿瘤切除术（TUR）加化疗高出30%。在治疗包膜内前列腺癌时，放疗是前列腺切除术的有效替代方案，在无病生存率方面结果相当。对于前列腺外疾病，由于局部控制率较低和血行转移，结果明显不那么令人满意。目前正在研究适形放疗以及新辅助和辅助激素疗法以改善治疗效果。
