在BCG疗法失败后NMIBC复发的患者中,在优化环境中使用埃皮鲁比进行高热静脉内化学疗法 (HIVEC)
Julien Blanc1, Jonathan Ruggiero1, Ilaria Lucca1
1Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
Cancers
|April 13, 2024
概括
使用epirubicin的高热静脉化疗 (HIVEC) 提供了一种有效的缓解膀癌的替代方案,用于在Bacillus Calmette-Guérin (BCG) 治疗后复发的非肌肉侵入性膀癌 (NMIBC),显示出高无复发生存率.
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.
- 医疗技术 医疗技术 医学技术
背景情况:
- 在Bacillus Calmette-Guérin (BCG) 治疗后,非肌肉侵入性膀癌 (NMIBC) 复发是一个重大的临床挑战.
- 经常考虑彻底的囊切除术,但具有相当大的发病率.
- 对于BCG耐药的NMIBC,需要有效的膀节约治疗选择.
研究的目的:
- 评估使用epirubicin的设备辅助高热静脉化疗 (HIVEC) 的疗效和安全性.
- 评估HIVEC作为一次性NMIBCBCBC后BCG治疗的患者的激进囊切除术的替代方案.
- 为了确定静脉无复发生存率 (RFS),并确定治疗失败的风险因素.
主要方法:
- 对39名在BCG治疗失败后复发的NMIBC患者的前性记录数据的回顾性分析.
- 患者在2017年11月至2022年11月期间在瑞士两个大学中心接受了HIVEC和epirubicin.
- 卡普兰-梅尔生存分析和考克斯回归被用于统计评估.
主要成果:
- 64%的患者在28个月的中位随访后仍然在膀内没有复发.
- 12个月和24个月的静脉无复发生存率分别为94.8%和80%.
- 18%的患者最终需要彻底切除囊;18%的患者进展为转移性疾病,往往先后出现异常复发.
结论:
- 使用epirubicin的设备辅助HIVEC在高风险NMIBC患者中显示出优异的静脉RFS率,这些患者在之前的BCG治疗中失败了.
- 虽然对静脉内控制有效,但静脉外复发仍然令人担忧,并与转移性进展和不良结果有关.
- 艾滋病毒EC代表了一个有前途的膀节省选择,但仔细监测extravesical传播至关重要.
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