【摘要翻译】局部微波高温和化疗对中高危险的表浅膀胱移行细胞癌的作用：欧洲的初步结果

[文题]Preliminary European Results of Local Microwave Hyperthermia and Chemotherapy Treatment in Intermediate or High Risk Superficial Transitional Cell Carcinoma of the Bladder
局部微波高温和化疗对中高危险的表浅膀胱移行细胞癌的作用：欧洲的初步结果
[来源]European Urology
[年、卷、期、页]2004. 46（1）：65-72
[作者]A. G. van der Heijden, L. A. Kiemeney, O. N. Gofrit, O. Nativ, A. Sidi, Z. Leib, R. Colombo, R. Nasprog, M. Pavone, J. Baniel, F. Hasner and J. A. Witjes
[原文摘要]
Introduction: Superficial bladder cancer can be treated by transurethral resection (TUR) and adjuvant intravesical therapy. Intravesical bacillus Calmette-Guérin (BCG) has been proven to be more efficacious with respect to recurrence prevention than intravesical chemotherapy, although at the cost of more severe side effects. There is a need for a new treatment modality with higher efficacy and less toxicity. The subject of this study is the efficacy of local microwave hyperthermia and chemotherapy treatment in intermediate or high risk superficial transitional cell carcinoma (TCC) of the bladder.

Patients and Methods: Ninety eligible patients received adjuvant treatment with a combination of mitomycin-C (MMC) and local microwave hyperthermia. All patients had multiple or recurrent Ta or T1 TCC of the bladder and were classified as intermediate or high risk according to EAU criteria. In total, 41 patients were BCG failures. The treatment regimen included 6 to 8 weekly sessions followed by 4 to 6 monthly sessions. Follow-up consisted of video-cystoscopy and urine cytology every 3 months. All patients were observed for 2 years.

Results: Kaplan–Meier analyses of the total group (N=90) indicated that 1 year after treatment only 14.3% (SE 4.5%) of all patients experienced a recurrence. After 2 years of follow-up the risk of recurrence was 24.6% (SE 5.9%). No progression in stage and grade was observed.

Conclusion: Microwave induced hyperthermia combined with MMC has promising value in intermediate or high risk superficial bladder cancer patients compared to literature data of BCG and/or intravesical chemotherapy, particularly where other treatments, i.e. BCG, have failed.
[中文译文]
介绍：表浅膀胱癌可以用经尿道切除（TUR）和辅助膀胱灌注化疗治疗。卡介苗（BCG）被证实在预防复发方面较膀胱灌注化疗效果更佳，虽然其副作用更大。需要一种新的治疗方法具有更佳效果和更小的毒性。本研究目的是评估局部微波高温和化疗对中高危险的表浅膀胱移行细胞癌（TCC）的作用。
病例和方法：90例符合条件的患者接受联合丝裂霉素-C（MMC）和局部微波高温的辅助治疗。所有的患者均为多发或复发的Ta或T1期的膀胱TCC并根据EAU的标准定为中高危险。共有41例患者为BCG治疗失败。治疗每周实施，共6-8次，随后改为每月实施，共4-6次。随访包括每3月的电视膀胱镜和尿细胞学检查。所有患者观察2年。
结果：对整组患者（N=90）进行Kaplan–Meier分析提示治疗后1年，只有14.3%（SE 4.5%）的患者经历1次复发。随访2年后，复发风险为24.6%（SE 5.9%）。未发现分期和分级的进展。
结论：相对于文献报告的BCG和/或膀胱灌注化疗,微波导致的高温联合MMC对中高危险的表浅膀胱肿瘤患者具有很有前景的价值，特别是对于其他治疗，例如BCG，失败的患者。
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[个人评论]百分之二十多的两年复发率还是相当令人满意的。