卡介苗供应标准化对非肌层浸润性膀胱癌患者治疗的影响共识文件。

Ó Rodríguez Faba, J M Fernández Gómez, F Guerrero-Ramos, M Álvarez-Maestro, M J Ledo Cepero, M Unda Urzaiz, L Martínez-Piñeiro, J M Cózar Olmo, J Palou Redorta, J L Álvarez-Ossorio
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引用次数: 0

摘要

非肌层浸润性膀胱癌(NMIBC)中、高危组患者必须在经尿道切除术(TUR)后接受膀胱内卡介苗(BCG)辅助治疗,因为它能降低复发风险,并可能降低病情恶化的风险。卡介苗疗效的优化是通过维持治疗来实现的。然而,由于卡介苗在膀胱中作用机制的许多免疫学方面仍然未知,因此在过去几十年中,最佳剂量、注射次数、菌株和适当的维持治疗方案的实施情况各不相同。此外,这也妨碍了从肿瘤结果的角度解释疗效。再加上近年来卡介苗短缺,迫使科学协会调整临床实践指南,修改卡介苗辅助治疗方案。这包括在此期间对菌株、剂量和维持量的改变。本共识文件评估了卡介苗辅助治疗的现状以及卡介苗供应情况对治疗 NMIBC 患者的影响。它还讨论了未来将改善癌症预后和 NMIBC 患者生活质量的新型疗法的实施情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Consensus document on the implications of standardization of BCG supply in the management of patients with non-muscle-invasive bladder cancer.

Patients with non-muscle-invasive bladder cancer (NMIBC) in the intermediate and high-risk groups must receive adjuvant treatment with intravesical Bacillus Calmette-Guérin (BCG) following transurethral resection (TUR), as it reduces the risk of recurrence and presumably the risk of progression as well. Optimization of BCG efficacy is achieved by administering maintenance therapy. However, since many immunological aspects of the mechanism of action of BCG in the bladder remain unknown, the implementation of the optimal dose, number of instillations, strains and adequate maintenance regimen over the last decades has been heterogeneous. Additionally, this has hindered the interpretation of efficacy in terms of oncologic outcomes. This, together with the shortages of BCG in recent years, have forced scientific societies to adapt their clinical practice guidelines and modify their protocols of adjuvant treatment with BCG. This includes changes to strains, doses, and maintenance during this period of time. This consensus document evaluates the current status of adjuvant BCG treatment and the implications of BCG supply availability in the treatment of patients with NMIBC. It also addresses the implementation of novel therapies that will improve cancer prognosis and the quality of life of patients with NMIBC in the future.

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