RTOG/NRG协议在形成当前膀胱保留治疗中的遗产在北美

IF 2.6 3区 医学 Q3 ONCOLOGY
Sophia C. Kamran MD, Jason A. Efstathiou MD, DPhil
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引用次数: 2

摘要

对于肌肉浸润性膀胱癌症,历史上的金标准治疗是根治性膀胱切除术。然而,使用三模态疗法(TMT,包括膀胱肿瘤的最大经尿道切除术,然后放化疗)保存器官的概念已被确立为完全切除膀胱的可行治疗替代方案。尽管缺乏TMT与根治性膀胱切除术的直接头对头随机比较,但放射治疗肿瘤组(RTOG)/NRG多年来一直率先将放射治疗作为膀胱保存的一部分,前瞻性数据表明,长期临床结果与膀胱切除术系列相似,尤其是在当代治疗中。我们总结了这些试验,并讨论了几十年来膀胱保存的演变,最终形成了我们目前的TMT方案。我们进一步讨论了MIBC中器官保留治疗的未来,包括放射技术的持续改进、新疗法的结合和个性化治疗,以优化癌症患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Legacy of RTOG/NRG Protocols in Shaping Current Bladder Preservation Therapy in North America

For muscle-invasive bladder cancer, the historical, gold standard treatment was radical cystectomy. However, the notion of organ preservation using trimodality therapy (TMT, consisting of maximal transurethral resection of bladder tumor followed by chemoradiation) has been established as a viable treatment alternative to complete removal of the bladder. Despite the lack of direct head-to-head randomized comparisons of TMT to radical cystectomy, the Radiation Therapy Oncology Group (RTOG)/NRG has spearheaded the use of radiation therapy as part of bladder preservation for years, with prospective data demonstrating similar long-term clinical outcomes to cystectomy series, particularly with contemporary treatment. We summarize these trials and discuss the evolution of bladder preservation throughout the decades, culminating in our current TMT protocols. We further discuss the future of organ-preservation therapy in MIBC, with continued improvement in radiation techniques, incorporation of novel therapies, and personalization of treatment to optimize benefit for bladder cancer patients.

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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
48
审稿时长
>12 weeks
期刊介绍: Each issue of Seminars in Radiation Oncology is compiled by a guest editor to address a specific topic in the specialty, presenting definitive information on areas of rapid change and development. A significant number of articles report new scientific information. Topics covered include tumor biology, diagnosis, medical and surgical management of the patient, and new technologies.
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