浸润性膀胱癌的术前放疗及新辅助化疗

膀胱移行细胞癌是国内泌尿系最常见的恶性肿瘤,初诊时约有20%为浸润性,另有10%浅表性肿瘤最终也将发展为浸润性膀胱癌.根治性膀胱全切术是浸润性膀胱癌的标准疗法,超过50%的浸润性膀胱癌患者将死于远处转移.为了降低膀胱癌全切术后的局部复发率、远处转移率和提高总生存率,放化疗与手术的综合治疗已应用于临床.为评价术前放疗及新辅助化疗在治疗浸润性膀胱癌中的应用价值,已进行了大量的临床试验,但迄今为止,尚缺乏足够的证据表明术前放疗及新辅助化疗可常规用于临床.

Preoperative radiotherapy and neoadjuvant chemotherapy in invasive bladder cancer

Bladder cancer is the most common cancer of the genitourinary tract in China.Transitional cell carcinoma(TCC)make up 90% of all bladder cancer.At presentation,approximately 20% of cases are invasive TCC,and 10% of those with superficial tumors will eventually develop invasive disease.The standard therapy in many courtries for T_2/T_3 N_0 muscle-invasive TCC of the bladder is radical cystectomy and urinary diversion.Up to 50% of these patients may die of distant metastasis.To decrease the incidence of local recurrence and distant metastasis and to improve the overall survival following radical cystectomy,radiotherapy and chemotherapy combined with surgery have been used.Many clinical studies have performed to test the benefit of preoperative irradiation and neoadjuvant chemotherapy in invasive bladder cancer.It is a pity that results of those clinical studies showed no conclusive benefit and a routine use of preoperative irradiation and neoadjuvant chemotherapy remains controversial.