肌层浸润性膀胱癌的新辅助化疗

Neoadjuvant chemotherapy in muscle-invasive bladder cancer

肌层浸润性膀胱癌(Muscle-Invasive Bladder Cancer,MIBC)是指临床分期为T2~T4的膀胱癌。具有进展快,易复发,易远处转移,恶性程度高,病死率高等特点。MIBC的标准治疗方法是根治性膀胱切除术(Radical Cystectomy,RC)同时行盆腔淋巴结清扫术(Pelvic Lymph Node Dissection,PLND),但是术后患者5年生存率只有27%~67%。我国指南已经推荐将以顺铂为基础的新辅助化疗作为MIBC的一线治疗方案。新辅助化疗则可以提高MIBC患者的5年生存率。现对新辅助化疗的化疗方案、现状以及研究方向等方面进行综述。

Muscle-invasive bladder cancer (MIBC)refers to the bladder cancer with clinical stage of cT2-cT4a .MIBC is characterized by the fast progress,apt to recurrence,likely to distant metastasis,high malignancy and high mortality.At present,radical cystectomy (RC)plus pelvic lymph node dissection (PLND)is considered the standard treatment for MIBC. However,the 5-year survival rate of patients with MIBC remains low,ranging from 27%-67%.In order to improve the on-cological outcome,guidelines recommend cisplatin-based neoadjuvant chemotherapy for the treatment of patients with MI-BC.Neoadjuvant chemotherapy could improve the 5-year survival of MIBC.This article reviews the optimal chemotherapy regimens,current status and future issues of the neoadjuvant chemotherapy.