磁共振成像与尿道外切除用于分期新的膀癌的随机比较:来自潜在的膀路径试验的结果
Richard T Bryan1, Wenyu Liu2, Sarah J Pirrie3
1Bladder Cancer Research Centre, Department of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.
概括
多参数磁共振成像 (mpMRI) 通过将治疗时间缩短45天,显著加快了肌肉侵入性膀癌 (MIBC) 的最终治疗. 这种mpMRI导向的方法证明对所有怀疑MIBC的患者都是有益的.
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.
- 放射学 放射学是一门学科.
背景情况:
- 膀瘤通过尿道切除 (TURBT) 是初始膀癌 (BC) 阶段的标准.
- 对于肌肉侵入性膀癌 (MIBC),TURBT可能会延迟关键的最终治疗.
- 研究替代的初始分期方法对于加快MIBC护理至关重要.
研究的目的:
- 评估灵活的囊泡镜活检和多参数磁共振成像 (mpMRI) 是否可以加快MIBC的初始分期.
- 为了比较MIBC的mpMRI-first和TURBT-first途径之间的时间纠正治疗 (TTCT).
- 对疑似膀癌的mpMRI导向途径的可行性和安全性进行评估.
主要方法:
- 这是一项前性,开放式,随机的,跨英国17家医院的研究.
- 怀疑BC的参与者被随机分为1:1分别接受TURBT阶段或mpMRI阶段的护理.
- 主要结局包括对MIBC的mpMRI和TTCT的可行性.
主要成果:
- 在92%的怀疑MIBC的参与者中,mpMRI是可行的.
- 对于MIBC,TTCT的中位数在初始mpMRI (53天) 与TURBT (98天) 相比显着较短 (P = .02).
- 对于非MIBC,没有观察到TTCT的显著差异,也没有报告任何严重的不良事件.
结论:
- 一个mpMRI导向的途径显著减少了45天的MIBC的TTCT.
- 在TURBT之前加入mpMRI对于所有怀疑MIBC的患者都是有益的.
- 这一战略简化了膀癌的诊断和治疗启动.
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