吡柔比星膀胱内灌注预防膀胱癌术后复发的临床研究

目的：探讨应用吡柔比星（THP）进行膀胱内灌注预防膀胱癌术后复发的疗效和安全性。方法：对68例初发的浅表性膀胱癌术后患者定期进行THP膀胱内灌注治疗,随访18—48个月。结果：全组无肿瘤复发率为85．3％,复发率为14．7％,29例于膀胱灌注期间出现膀胱刺激症状,其中4例因为不能耐受,暂停灌注,其余患者均完成治疗。所有患者未见明显的全身性药物反应。结论：THP膀胱内灌注预防膀胱癌术后复发的疗效满意,病人耐受性好,无全身性给药的毒副反应。     

溶瘤腺病毒治疗膀胱癌研究进展

全文综述溶瘤腺病毒用于膀胱癌治疗的策略和研究进展。     

羟基喜树碱膀胱内灌注治疗膀胱癌18例临床观察

目的:观察羟基喜树碱膀胱内灌注治疗晚期膀胱癌和膀胱癌术后复发患者的治疗效果与不良反应.方法:对18例晚期膀胱癌或膀胱癌术后复发患者采用羟基喜树碱20mg加生理盐水100 ml膀胱内灌注,每周一次,连用6次～8次,观察近期疗效和不良反应.结果:羟基喜树碱膀胱内灌注治疗晚期膀胱癌和膀胱癌术后复发患者的疗效明显,CR 4例,PR 10例,总有效率为77.8%,无明显不良反应.结论:羟基喜树碱膀胱内灌注治疗晚期膀胱癌或膀胱癌术后复发是有效的方法之一,值得推广应用.     

羟基喜树碱膀胱内灌注治疗膀胱癌18例临床观察

目的：观察羟基喜树碱膀胱内灌注治疗晚期膀胱癌和膀胱癌术后复发患者的治疗效果与不良反应。方法：对18例晚期膀胱癌或膀胱癌术后复发患者采用羟基喜树碱20mg加生理盐水100ml膀胱内灌注，每周一次，连用6次～8次，观察近期疗效和不良反应。结果：羟基喜树碱膀胱内灌注治疗晚期膀胱癌和膀胱癌术后复发患者的疗效明显，CR4例，PR10例，总有效率为77．8％，无明显不良反应。结论：羟基喜树碱膀胱内灌注治疗晚期膀胱癌或膀胱癌术后复发是有效的方法之一，值得推广应用。     

吡柔比星联合白细胞介素Ⅱ膀胱灌注预防浅表膀胱癌复发的初步研究

目的探讨吡柔比星(THP)联合白细胞介素Ⅱ(IL-2)预防浅表膀胱癌术后复发的近期疗效.方法对37例浅表性膀胱癌患者行经尿道膀胱肿瘤电切术(TURBt)或膀胱部分切除术,术后定期用THP 30 mg IL-2 100 000 U/40 ml做膀胱内灌注,每周1次,共8次;以后每月1次,共1年,每次药物在膀胱内保留40 min,随访结果与以往应用丝裂霉素C(MMC)的病例进行比较和讨论.结果随访10～24个月,7例复发,无瘤率为81.1%(30/37).THP IL-2组与MMC组(40 mg)相比差异无显著性(P>0.05).结论 THP联合IL-2用于临床膀胱灌注预防浅表膀胱癌术后复发效果好,不良反应少,给药方便,值得临床推广应用.     

膀胱内灌注血卟啉衍生物加抗坏血酸全膀胱激光照射预防膀胱癌复发

目的探讨预防膀胱癌术后复发的新疗法，评价经膀胱内灌注血卟啉衍生物加抗坏血酸行激光全膀胱照射的光动力疗法预防复发的疗效。方法采用经膀胱内灌注血卟啉衍生物癌光啉（ＰｓＤ－００７）加抗坏血酸行全膀胱激光照射方法，治疗３０例膀胱癌术后患者。结果３０例患者随诊３０个月，其肿瘤复发率为２３．３％（７／３０）。无一例发生膀胱挛缩以及皮肤光毒副反应。结论用膀胱内灌注血卟啉衍生物加抗坏血酸全膀胱照射能有效地预防膀胱癌的复发。在治疗过程中，受治患者无需避光护理，为治疗提供了方便。     

经尿道膀胱癌电切术后膀胱灌注化疗联合髂内动脉灌注化疗的疗效分析

 【摘要】　目的　观察膀胱癌经尿道膀胱肿瘤电切术后分别接受羟基喜树碱（HCPT）、吡柔比星（THP）膀胱灌注联合双侧髂内动脉灌注化疗患者的预后,评价比较HCPT及THP预防浸润性膀胱癌术后的疗效。方法　对2005年10月至2009年12月收治的89例TRUBT的膀胱癌患者,其中41例采用HCPT膀胱内灌注联合双侧髂内动脉灌注化疗,48例进行THP膀胱内灌注联合双侧髂内动脉灌注化疗。对两组患者的缓解率、复发率、不良反应发生率以及膀胱癌肿瘤标志物进行分析。结果　术后HCPT组缓解率为73.13 %（30／41）,复发率为36.67 %（11／30）,不良反应发生率为48.78 %（20／41）,THP组缓解率为89.58 %（43／48）,复发率为16.28 %（7／43）,不良反应发生率为39.58 %（18／48）,两组治疗前后膀胱癌肿瘤标志物差异均有统计学意义（P值均＜0.05）。结论　TRUBT术后膀胱灌注化疗联合髂内动脉灌注化疗治疗浸润性膀胱癌安全有效,术后复发率低,且THP膀胱灌注效果优于HCPT。     

经尿道膀胱癌电切术后膀胱灌注化疗联合髂内动脉灌注化疗的疗效分析

目的 观察膀胱癌经尿道膀胱肿瘤电切术后分别接受羟基喜树碱(HCPT)、吡柔比星(THP)膀胱灌注联合双侧髂内动脉灌注化疗患者的预后,评价比较HCPT及THP预防浸润性膀胱癌术后的疗效.方法 对2005年10月至2009年12月收治的89例TRUBT的膀胱癌患者,其中41例采用HCPT膀胱内灌注联合双侧髂内动脉灌注化疗,48例进行THP膀胱内灌注联合双侧髂内动脉灌注化疗.对两组患者的缓解率、复发率、不良反应发生率以及膀胱癌肿瘤标志物进行分析.结果 术后HCPT组缓解率为73.13%(30/41),复发率为36.67%(11/30),不良反应发生率为48.78%(20/41),THP组缓解率为89.58%(43/48),复发率为16.28%(7/43),不良反应发生率为39.58%(18/48),两组治疗前后膀胱癌肿瘤标志物差异均有统计学意义(P值均＜0.05).结论 TRUBT术后膀胱灌注化疗联合髂内动脉灌注化疗治疗浸润性膀胱癌安全有效,术后复发率低,且THP膀胱灌注效果优于HCPT.     

经尿道膀胱癌电切术后膀胱灌注化疗联合髂内动脉灌注化疗的疗效分析

目的 观察膀胱癌经尿道膀胱肿瘤电切术后分别接受羟基喜树碱(HCPT)、吡柔比星(THP)膀胱灌注联合双侧髂内动脉灌注化疗患者的预后,评价比较HCPT及THP预防浸润性膀胱癌术后的疗效.方法 对2005年10月至2009年12月收治的89例TRUBT的膀胱癌患者,其中41例采用HCPT膀胱内灌注联合双侧髂内动脉灌注化疗,48例进行THP膀胱内灌注联合双侧髂内动脉灌注化疗.对两组患者的缓解率、复发率、不良反应发生率以及膀胱癌肿瘤标志物进行分析.结果 术后HCPT组缓解率为73.13%(30/41),复发率为36.67%(11/30),不良反应发生率为48.78%(20/41),THP组缓解率为89.58%(43/48),复发率为16.28%(7/43),不良反应发生率为39.58%(18/48),两组治疗前后膀胱癌肿瘤标志物差异均有统计学意义(P值均＜0.05).结论 TRUBT术后膀胱灌注化疗联合髂内动脉灌注化疗治疗浸润性膀胱癌安全有效,术后复发率低,且THP膀胱灌注效果优于HCPT.     

非肌层浸润性膀胱癌治疗现状及进展

摘 要：大部分膀胱癌为非肌层浸润性癌,其标准治疗方法为经尿道膀胱肿瘤电切术,但术后复发率高,一部分患者会发展为肌层浸润性癌,对于具有复发和进展危险因素的患者采用膀胱内灌注免疫制剂或化疗药物治疗,膀胱内灌注标准药物无效的患者采用根治性膀胱全切术,新的治疗方法正在进行临床试验,如果有效,将提高非肌层浸润性膀胱癌的治疗效果。     

Neoadjuvant chemotherapy in muscle-invasive bladder cancer

Radical cystectomy is the standard treatment for patients with muscle-invasive bladder cancer. Bladder cancer is a chemoresponsive disease and should be dealt with in a multimodality approach. Neoadjuvant chemotherapy is intended for patients with operable clinical stage T2 to T4a muscle-invasive disease to improve survival. Meta-analysis of cisplatin-containing combination neoadjuvant chemotherapy trials revealed a 5% difference in favor of neoadjuvant chemotherapy. Bladder preservation in selected patients on the basis of response to neoadjuvant chemotherapy is a feasible approach. The goal now must be to find more effective drugs and to better predict the individual response to therapy.     

Bladder cancer

Bladder cancer is a significant public health problem responsible for more than 130,000 deaths annually worldwide. Disease prevalence is also remarkable, with more than 500,000 patients carrying the diagnosis in the United States alone. Significant progress has been made in understanding the underlying molecular and genetic events in bladder cancer. However, there remains a great need for the development of reliable markers that can provide clinically useful information regarding diagnosis and prognosis and to facilitate the selection of appropriate therapy in the individual patient. Ongoing and future investigation is anticipated to refine treatment of patients with high-risk superficial disease, to determine the role of neoadjuvant and adjuvant chemotherapy for high-risk invasive disease, and to improve the efficacy of chemotherapy for patients with metastatic bladder cancer.     

Noninvasive approaches for detecting and monitoring bladder cancer

Bladder cancer is the second most common cancer of the urinary tract. Despite existing multiapproach treatment strategies, including radical cystectomy, bladder-sparing therapy with transurethral resection, chemotherapy and radiotherapy, patients with deeply invasive bladder cancers display poor prognosis, with a survival rate of only 30–50%. This can be avoided through proper surveillance and monitoring. Several genetic factors contribute to the progression of bladder cancer, and these molecules serve as cancer biomarkers. Blood, plasma, serum and urine are commonly analyzed for the presence of biomarkers, which can be both nuclear as well as mitochondrial in nature. This review discusses the efficacy of such biomarkers as well as highlights some potential prognostic markers in the field of noninvasive bladder cancer detection.     

Bladder cancer

PURPOSE OF REVIEW: This article reviews recent advances in the diagnosis and management of bladder cancer. RECENT FINDINGS: Bladder cancer is a significant cause of morbidity and mortality. Recent research has attempted to improve the care of patients with this disease. Evidence suggests that bacillus Calmette-Guerin is the most effective intravesical therapy for the treatment of superficial bladder cancer and that maintenance therapy is superior to an induction course alone. In patients with muscle-invasive disease, nodal status and extent of lymphadenectomy have been shown to correlate with survival after radical cystectomy. The role of chemotherapy in the treatment of bladder cancer continues to evolve as well. Neoadjuvant chemotherapy has recently demonstrated a survival benefit, and trials are ongoing to define the optimal regimen of chemotherapy for urothelial carcinoma. SUMMARY: Improved understanding and advancements in the management of all stages of bladder cancer continue to improve the care of patients with this disease.     

非编码RNA在膀胱癌中的研究进展

膀胱癌是全世界最常见的癌症之一,虽然手术结合化疗和放疗在一定程度上改善了患者的预后,但大多数肌肉浸润性膀胱癌患者的预后仍然很差。而且,膀胱癌的确切机制和关键调节因子尚不清楚。最近的研究表明,一些非编码RNA在膀胱癌中表达失调,对膀胱癌的发生发展起着至关重要的作用。更重要的是,非编码RNA可作为膀胱癌的诊断和预后的生物标志物。本综述旨在总结近期的研究进展,这些研究表明了包括miRNA、lncRNA、circRNA在内的三类非编码RNA在膀胱癌中的调控机制,以及它们作为临床诊断或预后生物标志物的潜在作用。     

肌层浸润性膀胱癌分子预后标记物研究进展

膀胱癌是泌尿系统常见肿瘤, 可分为非肌层浸润性膀胱癌、肌层浸润性膀胱癌和转移性膀胱癌。临床上患者多为非肌层浸润性膀胱癌, 易于复发, 复发后大多数细胞分化良好, 预后佳。但10%~30%患者肿瘤复发时转变为具有侵袭性的浸润性膀胱癌, 预后不良。目前临床上采用的分级分期方法很难准确预测具有复杂生物学行为的浸润性膀胱癌的预后。近年许多肿瘤标记物相继被发现并用于浸润性膀胱癌的诊断和预后判断。这些分子标记物不仅对浸润性膀胱癌患者预后的判断有提示作用, 同时决定着患者是否适合行保留膀胱的放化疗、新辅助化疗和以铂类为基础的辅助化疗等治疗方式。本文对影响浸润性膀胱癌预后的分子标记物进行综述。      

膀胱癌诊断标志物研究进展

膀胱癌发病率逐年增高且易复发,如能早期诊断,早期治疗,患者生存状况将会明显改善。目前用于临床膀胱癌检测的肿瘤标记物的研究主要集中在NMP22、Survivin、HA-HAase、BTA,UBC、TLMA、CD44V6、L-selectin、MCM5、p27、MSI、FB/FDP、VEGF、BGA、integrin、centrosome等。对于不同发展阶段或不同类型的膀胱癌,单一肿瘤标志物检测的灵敏度有不同程度的差异。它们最有价值的潜在作用是监测膀胱癌复发和筛查有膀胱刺激征和血尿的患者,并且几种肿瘤标志物的合理联合应用将成为诊断膀胱癌的有效工具。     

Key concerns about the current state of bladder cancer

Bladder cancer is the fifth most common cancer in the United States and, on a per capita basis, is the most expensive cancer from diagnosis to death. Unfortunately, National Cancer Institute funding for bladder cancer is quite low when compared with other common malignancies. Limited funding has stifled research opportunities for new and established investigators, ultimately encouraging them to redirect research efforts to other organ sites. Waning interest of scientists has further fueled the cycle of modest funding for bladder cancer. One important consequence of this has been a lack of scientific advancement in the field. Patient advocates have decidedly advanced research efforts in many cancer sites. Breast, prostate, pancreatic, and ovarian cancer advocates have organized highly successful campaigns to lobby the federal government and the medical community to devote increased attention and funding to understudied malignancies and to conduct relevant studies to better understand the therapy, diagnosis, and prevention of these diseases. Bladder cancer survivors have lacked a coordinated advocacy voice until recently. A concerted effort to align bladder cancer advocates, clinicians, and urologic organizations is essential to define the greatest needs in bladder cancer and to develop related solutions. This position paper represents a collaborative discussion to define the most concerning trends and greatest needs in the field of bladder cancer as outlined by the Bladder Cancer Think Tank, the Bladder Cancer Advocacy Network, and the Society of Urologic Oncology. Cancer 2009. © 2009 American Cancer Society.     

浅表性膀胱癌的灌注治疗

膀胱癌是泌尿系统最常见的恶性肿瘤之一，其中70％～80％是以反复复发为特点的浅表性膀胱癌。防止肿瘤发生、进展和侵袭转移是降低膀胱癌复发率和病死率的关键。对浅表性膀胱癌灌注治疗的研究进展进行综述。