2018年EAU非肌层浸润性膀胱癌的指南解读——BCG免疫治疗篇
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摘要
欧洲泌尿外科学会于2018年3月颁布了《非肌层浸润性膀胱癌指南(2018年版)》。新指南在非肌层浸润性膀胱癌的分类分期分级、基于循证医学的流行病学情况、诊断标准、安全而有效的治疗等方面做了论述。本文重点对其中BCG膀胱内灌注免疫治疗部分进行解读,包括BCG的疗效、菌株、毒力、副作用及相关治疗、最佳剂量及疗程、治疗指征、治疗不成功的原因分类及治疗失败后治疗。
In March 2018, the European Association of Urology issued the Guidelines for Non-muscle-invasive Bladder Cancer(2018 edition). The new guideline described the classification, staging, epidemiology of evidencebased medicine, diagnosis, safe and effective treatment of non-muscle-invasive bladder cancer. This article focuses on the part of intravesical BCG immunotherapy, including the efficacy, strains, toxicity, side effects,optimal BCG schedule, optimal dose of BCG, indications, categories of unsuccessful treatment, treatment of BCG failure and recurrences after BCG.
In March 2018, the European Association of Urology issued the Guidelines for Non-muscle-invasive Bladder Cancer(2018 edition). The new guideline described the classification, staging, epidemiology of evidencebased medicine, diagnosis, safe and effective treatment of non-muscle-invasive bladder cancer. This article focuses on the part of intravesical BCG immunotherapy, including the efficacy, strains, toxicity, side effects,optimal BCG schedule, optimal dose of BCG, indications, categories of unsuccessful treatment, treatment of BCG failure and recurrences after BCG.
引文
[1]那彦群,李宁忱,李鸣.膀胱癌临床诊断与治疗[M].北京:人民卫生出版社, 2012:86-90.
[2]Hall MC, Chang SS, Dalbagni G, et al. Guideline for the Management of Nonmuscle Invasive Bladder Cancer(Stages Ta, T1, and Tis):2007 Update[J]. J Urol, 2007, 178(6):2314-2330.
[3]Berrumsvennung I, Granfors T, Jahnson S, et al. A single instillation of epirubicin after transurethral resection of bladder tumors prevents only small recurrences[J]. Journal of Urology, 2008, 179(1):101-106.
[4]European Association of Urology. EAU Guidelines:Nonmuscle-invasive Bladder Cancer. presented at the EAU Annual Congress Copenhagen 2018[EB/OL]. http://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/#7
BCG治疗中或治疗后患者的低级别复发不认为是BCG治疗失败
[2]Hall MC, Chang SS, Dalbagni G, et al. Guideline for the Management of Nonmuscle Invasive Bladder Cancer(Stages Ta, T1, and Tis):2007 Update[J]. J Urol, 2007, 178(6):2314-2330.
[3]Berrumsvennung I, Granfors T, Jahnson S, et al. A single instillation of epirubicin after transurethral resection of bladder tumors prevents only small recurrences[J]. Journal of Urology, 2008, 179(1):101-106.
[4]European Association of Urology. EAU Guidelines:Nonmuscle-invasive Bladder Cancer. presented at the EAU Annual Congress Copenhagen 2018[EB/OL]. http://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/#7
BCG治疗中或治疗后患者的低级别复发不认为是BCG治疗失败