侵入性非肌肉膀胱癌中的射频诱导热：真实情况下的肿瘤结果

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-06-01 DOI:10.1016/j.acuro.2025.501746

S. Mero , K. Oberneder , J. Weiss , E. Grobet-Jeandin , A. Grégoris , P. Sèbe , S. Shariat , D. D’Andrea

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引用次数: 0

摘要

目的：非肌肉浸润性膀胱癌（NMIBC）患者经尿道膀胱切除术后复发和进展的风险高，需要辅助治疗。膀胱内装置辅助治疗，如射频诱导热化疗（RITE），已显示出增强膀胱内化疗有效性的希望。本研究旨在评估在现实环境中接受RITE治疗的NMIBC患者的肿瘤学结果，包括那些先前对卡介苗（BCG）或膀胱化疗无反应的患者，以及那些拒绝或不符合卡介苗或根治性膀胱切除术（RC）的患者。方法对2015年至2024年接受RITE治疗的NMIBC患者进行回顾性多中心分析。该研究的共同主要终点是膀胱内无复发生存期（RFS）和高度膀胱内无复发生存期（HG-RFS）。次要终点包括无根治性膀胱切除术生存期（RC-FS）、总生存期（OS）、癌症特异性生存期（CSS）和不良事件（ae）。结果59例患者连续纳入最终分析。总体而言，分别有12例（20%）和45例（76%）患者在之前的膀胱化疗和卡介苗免疫治疗中失败。RITE后24个月RFS和HG-RFS分别为68.6% （95% CI: 0.568, 0.828）和74.8% （95% CI: 0.632, 0.885）。24个月时RC-FS为93.8% （95% CI: 0.872, 1.000）。24个月时的OS概率为91%，CSS为97.8%。最常见的ae是27例（45.7%）患者的排尿困难和尿急，11例（19%）患者的治疗限制了膀胱痉挛，11例（19%）患者的膀胱依从性低，5例（8%）患者的尿道狭窄。结论：在我们的分析中，RITE产生了显著的抗肿瘤活性，并允许避免更积极和限制生活质量的治疗，如根治性膀胱切除术。对于先前膀胱内治疗失败的患者，RITE可能被认为是保留膀胱的二线选择。需要长期随访和更大规模的数据来验证我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Hipertermia inducida por radiofrecuencia en el cáncer de vejiga no músculo invasor: resultados oncológicos en un escenario real

Objectives

Patients with non-muscle invasive bladder cancer (NMIBC) face a high risk of recurrence and progression after transurethral resection, making adjuvant therapies necessary. Intravesical device-assisted therapies, such as radiofrequency-induced thermochemotherapy (RITE), have shown promise in enhancing the effectiveness of intravesical chemotherapies. This study aimed to evaluate oncological outcomes in patients with NMIBC treated with RITE in a real-world setting, encompassing those unresponsive to prior Bacillus Calmette-Guérin (BCG) or intravesical chemotherapy, as well as those who declined or were ineligible for BCG or radical cystectomy (RC).

Methods

A retrospective multicenter analysis of patients treated with RITE for NMIBC between 2015 and 2024 was performed. Co-primary endpoints of the study were intravesical recurrence free survival (RFS) and high-grade intravesical recurrence free survival (HG-RFS). Secondary endpoints included radical cystectomy-free survival (RC-FS), overall survival (OS), cancer-specific survival (CSS), and adverse events (AEs).

Results

Fifty-nine consecutive patients were included in the final analyses. Overall, 12 (20%) and 45 (76%) patients failed previous intravesical chemotherapy, and immunotherapy with BCG, respectively. The 24-months RFS and HG-RFS following RITE were 68.6% (95% CI: 0.568, 0.828) and 74.8% (95% CI: 0.632, 0.885). RC-FS at 24 months was 93.8% (95% CI: 0.872, 1.000). The OS probability at 24 months was 91%, with a CSS of 97.8%. Most common AEs were dysuria and urgency in 27 (45.7%) patients, treatment limiting bladder spasms in 11 (19%) patients, low bladder compliance in 11 (19%) patients and urethral strictures in 5 (8%) patients.

Conclusions

In our analyses, RITE resulted in notable antitumor activity and allows for the avoidance of more aggressive and quality-of-life-limiting therapies, such as radical cystectomy. RITE might be considered as a second-line bladder-sparing option in patients failing previous intravesical therapies. Long-term follow-up and larger-scale data are required to validate our findings.

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.