在中等和高风险的非肌肉侵入性膀癌中,辅助性高热肠道化疗
Joana C Magalhães1, Maria Sousa2, Raquel Basto3
1Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT.
Cureus
|September 25, 2023
概括
使用米托米辛C (HIVEC-MMC) 进行的高温静脉化疗显示出对非肌肉侵入性膀癌 (NMIBC) 的耐受性和疗效有前途. 这种治疗是中等或高风险NMIBC患者的可行替代方案,特别是当Bacillus Calmette-Guérin (BCG) 不适合时.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 癌症治疗方法 癌症治疗方法
背景情况:
- 非肌肉侵袭性膀癌 (NMIBC) 通常通过尿道切除膀瘤 (TURBT) 进行治疗,然后进行静脉内疗法,如Bacillus Calmette-Guérin (BCG) 或Mitomycin C (MMC).
- 与BCG相关的局限性推动了寻找替代辅助治疗的研究.
- 与MMC (HIVEC-MMC) 进行的高热静脉化疗已成为NMIBC管理的潜在替代方案.
研究的目的:
- 评估HIVEC-MMC在中等风险 (IR) 和高风险 (HR) NMIBC患者的耐受性和合规性.
- 评估与HIVEC-MMC治疗相关的无病生存 (DFS) 和总生存 (OS) 结果.
- 在接受HIVEC-MMC.的NMIBC患者中确定治疗成功的预测因素.
主要方法:
- 一个单一中心的回顾性分析包括57名IR和HR-NMIBC患者,这些患者在TURBT后接受了HIVEC-MMC.
- 治疗方案包括HIVEC-MMC的诱导 (4次每周插入) 和维持 (6次每月插入).
- 统计分析包括描述性统计,Kaplan-Meier生存估计和Cox/逻辑回归来评估结果.
主要成果:
- 在57名患者中,41名 (71.9%) 完成了HIVEC-MMC协议;复发和不良事件是停止治疗的主要原因.
- 在平均31个月的随访后,61.4%的患者无病,平均DFS为42个月.
- 维护阶段的完成是DFS (p < 0.001) 的显著预测因素,并且在排除复发时 (p = 0.021) 对OS产生了积极影响.
结论:
- 艾滋病毒EC-MMC显示出安全且耐受性良好的特征,在IR和HR-NMIBC中具有有前途的疗效.
- 这种方法为那些不能耐受BCG或有禁忌的NMIBC患者提供了可行的治疗选择.
- 艾滋病毒EC-MMC作为一种有价值的替代品,特别是在BCG短缺期间.
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