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基于西斯普拉丁的新辅助化疗对接受激进囊切除术的患者功能的影响
Matthew D Ho1, Anna J Black1, Homayoun Zargar1,2
1Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
概括
在激进囊切除术 (RC) 之前的新辅助化疗 (NAC) 在膀癌患者中显著降低了功能,使慢性病风险翻倍. 没有NAC的患者在手术后的衰退较小.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
背景情况:
- 基于西斯普拉丁的新辅助化疗 (NAC) 是激进囊切除术 (RC) 之前肌肉侵入性膀癌 (MIBC) 的标准.
- 西斯普拉丁和RC独立地存在损伤的风险,影响估计的淋巴细胞过率 (eGFR).
研究的目的:
- 评估基于西斯的NAC和RC对MIBC患者功能的综合作用.
- 为了比较接受NAC+RC和单独接受RC的患者之间的功能变化.
主要方法:
- 对MIBC患者的多中心数据库进行了回顾性分析,这些患者接受了NAC,其次是RC.
- 在三个时间点收集的eGFR:NAC前,NAC后/RC前,RC后一年.
- 在NAC和非NAC队列之间比较EGFR和慢性病 (CKD) 阶段≥3发病率.
主要成果:
- NAC队列 (n=234) 显示,RC后一年的EGFR平均下降率为17%.
- 在NAC队列中,CKD阶段≥3的患者比例几乎翻了一番 (27%至50%).
- 非NAC队列 (n=236) 具有较低的基线eGFR,但较少的eGFR下降 (6%) 和类似的CKD阶段≥3发病率 (37%至51%) 在RC后一年.
结论:
- 在RC之前的NAC与显著的功能下降和CKD发病率增加有关.
- 没有NAC的RC导致手术后一年的功能损失较少,尽管基线CKD率较高.
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