在中等风险的非肌肉侵入性膀癌中维持治疗的价值
Paolo Zaurito1,2, Pietro Scilipoti1,2, Mattia Longoni1,2
1Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
BJU international
|August 22, 2025
概括
维持治疗对具有多种风险因素的中等风险非肌肉侵入性膀癌 (IR- NMIBC) 患者有好处. 国际膀癌组 (IBCG) 的风险分层有助于定制治疗决策以更好地控制复发.
科学领域:
- 尿道病学
- 癌症学
- 癌症研究
背景情况:
- 非肌肉侵入性膀癌 (NMIBC) 的复发是一个重大问题.
- 中期风险NMIBC (IR-NMIBC) 管理问题,特别是关于维持治疗的问题.
- 国际膀癌组 (IBCG) 的风险分层工具根据复发风险对患者进行分类.
研究的目的:
- 确定哪些IR-NMIBC患者受益于维持性静脉内治疗.
- 评估IBCG风险分层在指导维持治疗决策中的有用性.
- 根据IBCG风险因素和治疗持续时间分析复发和进展风险.
主要方法:
- 对464名IR-NMIBC患者 (2010-2023) 的前性数据库进行了回顾性分析.
- 在诱导治疗后,患者接受了静脉内化学疗法或Bacillus Calmette- Guérin (BCG).
- 使用IBCG风险分层 (0, 1-2,3+风险因素) 和Cox回归模型来评估维持治疗的益处.
主要成果:
- 在患有1至2个或3个或更多IBCG危险因子的患者中,维持治疗与复发率显著降低有关.
- 没有IBCG危险因子的患者在维持治疗中出现类似的复发率.
- 通过IBCG分层,有效地确定了受益于延长内治疗的患者子组.
结论:
- IBCG风险分层是定制IR-NMIBC维持治疗的一个有价值的工具.
- 对于具有一个或多个IBCG危险因子的IR-NMIBC患者,应考虑进行维护性静脉内治疗.
- 根据IBCG分层进行风险调整的治疗策略可以优化IR-NMIBC患者的治疗结果.
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