肌层浸润性膀胱癌的精准新辅助化疗进展研究

Advances in precision neoadjuvant chemotherapy for muscle-invasive bladder cancer

膀胱癌是泌尿系统最常见的恶性肿瘤,其中肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)占25%~30%。MIBC的标准治疗方式为新辅助化疗(neoadjuvant chemotherapy,NAC)+膀胱癌根治术,而只行根治术的5年生存率低。NAC虽可杀灭微转移癌病灶,使肿瘤降期,提高患者的总生存率,仅化疗后病理降期可使患者生存获益,无效的化疗可能会延误患者治疗,如何精准选择行NAC的患者是临床面临的难题。本文将对MIBC的NAC的应用现状及疗效预测进行综述。

Urinary bladder cancer is the most common malignant tumor of the urinary system.Muscle-invasive bladder cancer(MIBC)accounts for 25%-30%of bladder cancer cases.The 5-year overall survival rate in patients with MIBC treated with radical cystectomy alone is low.Neoadjuvant chemotherapy(NAC)combined with radical cystectomy is the standard treatment for localized MIBC.NAC can destroy micrometastasis foci,downstage tumors,and improve the overall survival of patients;however,NAC is only effective in pT≤T1 patients after chemotherapy.Ineffective chemotherapy may delay patients treatment.How to accurately select patients for NAC is a serious conundrum for clinical workers.This article will review the application status and efficacy prediction of MIBC's NAC.