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首页> 外文期刊>Expert opinion on biological therapy >Current intravesical therapy for non-muscle invasive bladder cancer
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Current intravesical therapy for non-muscle invasive bladder cancer

机译：当前非肌肉浸润性膀胱癌的膀胱内治疗

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Introduction: Transurethral resection of the bladder tumour (TURBT) is still the standard initial treatment for non-muscle invasive bladder cancer (NMIBC). However, even after a radical resection, recurrence (30-80%) and progression (1-45%) are commonly seen. Intravesical therapy provides direct contact of the agent with the bladder mucosa and clearly has improved the outcome, especially in high-risk disease. Areas covered: The role of a good initial TURBT is emphasized. Risk assessment tools are discussed. Different intravesical therapies are enumerated according to the latest literature, with the emphasis on Bacillus Calmette-Guérin (BCG), including the discussion on the optimal dose and schedule. New developments are mentioned. Expert opinion: A radical TURBT is essential for good prognosis. For optimal visualisation of tumours, fluorescence techniques should be used with low threshold, especially in case of suspicion of carcinoma in situ (CIS). Increased completeness of the resection will lead to less persisting disease and less need for adjuvant treatment. A re-TURBT should be done when in doubt of radical resection (judged by the pathologist or the surgeon). Risk assessment is essential, but the available tools are outdated. A single post-operative instillation (SPI) with chemotherapy is only indicated in low-risk disease. BCG is the treatment of choice for high-grade disease. BCG should be given as maintenance. Awareness of deterioration of the prognosis after progression is of great importance. In BCG failures, cystectomy should be strongly advised. Chemotherapy in combination with hyperthermia seems to be a new promising treatment.
机译：简介：经尿道膀胱肿瘤切除术（TURBT）仍然是非肌肉浸润性膀胱癌（NMIBC）的标准初始治疗方法。但是，即使进行了根治性切除，也通常会看到复发（30-80％）和进展（1-45％）。膀胱内治疗使药物与膀胱粘膜直接接触，明显改善了结局，尤其是在高危疾病中。涵盖的领域：强调良好的初始TURBT的作用。讨论了风险评估工具。根据最新文献，列举了不同的膀胱内疗法，重点是卡介苗（BCG），包括有关最佳剂量和时间表的讨论。提到了新的发展。专家意见：彻底的TURBT对于良好的预后至关重要。为了使肿瘤最佳可视化，应使用低阈值的荧光技术，尤其是在怀疑原位癌（CIS）的情况下。切除完整性的提高将导致较少的持续性疾病和较少的辅助治疗。如果怀疑根治性切除术（由病理学家或外科医生判断），则应重新进行TURBT。风险评估是必不可少的，但是可用的工具已过时。仅在低危疾病中使用化疗后进行单次滴注（SPI）。卡介苗是治疗高度疾病的一种选择。卡介苗应给予维护。对进展后预后恶化的认识非常重要。对于卡介苗失败，应强烈建议行膀胱切除术。化学疗法与热疗相结合似乎是一种新的有前途的治疗方法。

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