上尿路尿路上皮癌术后膀胱灌注化疗的研究进展

Research development of postoperative intravesical chemotherapy for upper tract urothelial carcinoma

根治性肾输尿管切除术联合膀胱袖状切除术是高级别上尿路尿路上皮癌的治疗金标准。由于尿路上皮癌具有多中心的特点,有22%~47%的患者术后会出现膀胱肿瘤复发。多个随机对照试验结果显示,术后膀胱内灌注化疗药,可有效降低术后膀胱内复发率。目前,上尿路尿路上皮癌的术后膀胱灌注治疗方案及药物仍参考膀胱尿路上皮癌,还未形成标准的治疗方案。本文对近年来灌注治疗形式及药物的选择等方面的研究进展进行综述。

Radical nephroureterectomy with bladder cuff resection is the gold standard for the treatment of high-grade upper tract urothelial carcinoma.Due to the multicenter characteristics of urothelial carcinoma,22%to 47%of patients still have bladder tumor recurrence after operation.A series of randomized controlled trials have shown that postoperative intravesical chemotherapy can effectively reduce the intravesical recurrence rate after operation.At present,postoperative intravesical instillation treatment and drugs still refer to bladder urothelial carcinoma,and the standard treatment has not been established yet.This article reviews the relevant literature in recent years,and systematically discusses the research development of postoperative intravesical chemotherapy in terms of the choice of chemotherapy protocol and drugs.