在肌肉侵入性膀癌中使用剂量密集的MVAC进行新辅助化疗:三级中心的经验
Marina Serrano1, Nerea Muñoz-Unceta1, Lucía Andrea Alonso1
1Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
概括
新辅助剂剂量密度高的甲状腺,芬布拉斯,多克索鲁比辛和西斯普拉丁 (dd-MVAC) 化疗在肌肉侵入性膀癌 (MIBC) 患者中显示出有效性,达到高的病理完整反应率和可控副作用的下降阶段.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医学瘤学 医学瘤学
- 膀癌研究 膀癌研究
背景情况:
- 新辅助化疗改善了肌肉侵入性膀癌 (MIBC) 的生存率.
- 对MIBC的最佳新辅助化疗方案仍在研究中.
- 剂量密集的甲状腺素,维布拉斯,多克索鲁比和西斯 (dd-MVAC) 是一个潜在的治疗方案.
研究的目的:
- 为了评估新辅助dd-MVAC的临床和病理结局,然后在MIBC患者中进行激进囊切除术.
- 评估dd-MVAC疗法的疗效和毒性概况.
- 确定dd-MVAC是否是其他标准新辅助治疗的可行替代方案.
主要方法:
- 对42名MIBC患者进行了回顾性分析,这些患者接受了4个周期的新辅助dd-MVAC治疗.
- 患者患有临床阶段T2或更高的非转移性疾病.
- 结果包括病理反应,下降阶段,不良事件和激进囊切除术后疾病复发.
主要成果:
- 50%的患者实现了完全的病理反应 (ypT0,ypN0).
- 57.1%的患者经历了瘤下降阶段.
- 最常见的不良事件是喘息 (81%) 和中性衰竭 (38%).
- 经过平均31.5个月的随访后,33.3%的患者出现了疾病复发.
结论:
- 新辅助剂dd-MVAC是一种有效的MIBC治疗方案,产生高率的病理完整反应和下降阶段.
- dd-MVAC的毒性概况是可以接受的.
- 对于表现良好的患者,应该考虑使用DD-MVAC作为西斯普拉丁和吉姆丁的替代品.
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