欧盟膀胱癌Guidelines(辅助治疗部分,中英文对照)教程分析.docx

Guidelines onNon-muscle-invasive Bladder Cancer(Ta, T1 and CIS)非肌层浸润性膀胱癌（Ta期和T1期及CIS）指南 M. Babjuk (chair), A. B?hle, M. Burger, E. Compérat, E. Kaasinen, J. Palou, B.W.G. van Rhijn, M. Rouprêt, S. Shariat, R. Sylvester, R. Zigeuner ? European Association of Urology 2014?欧洲泌尿外科学会2014版权所有European Association of Urology欧洲泌尿外科学会8. ADJUVANT TREATMENT辅助治疗 8.1 Intravesical chemotherapy膀胱内化疗 Although state-of-the-art TURB by itself can eradicate a Ta, T1 tumour completely, these tumours commonly recur and can progress to MIBC. The high variability in the 3-month recurrence rate indicates that TURB is incomplete or provokes recurrences in a high percentage of patients (90). It is therefore necessary to consider adjuvant therapy in all patients.尽管最先进的TURB本身能够根除Ta期和T1期肿瘤，但是这些肿瘤普遍复发并可能发展为MIBC。3个月复发率的高度变异性表明，TURB并不完备或激发高比例患者复发（90）。因而有必要考虑为所有患者考虑辅助疗法。 8.1.1 A single, immediate, post-operative intravesical instillation of chemotherapy单个的术后即时膀胱灌注化疗 Early single instillation has been shown to act by the destruction of circulating tumour cells resulting from TURB, and by an ablative effect (chemoresection) on residual tumour cells at the resection site and on small overlooked tumours (143-146) (LE: 3).早期单个灌注表现为，通过破坏TURB产生的循环肿瘤细胞，通过对切除部位的残余肿瘤细胞、对被忽略的小肿瘤的烧蚀作用（化疗切除术）来起作用（143-146）（LE: 3）。 Three large meta-analyses comprising 1476 to 3103 patients have consistently shown that one immediate instillation of chemotherapy after TURB significantly reduced the recurrence rate by 11.7% to 13.0% compared to TURB alone (147-149) (LE: 1a). Although none of the three meta-analyses adequately answered the question concerning which patients benefitted the most from an immediate instillation, some underpowered data from two subgroup analyses (150,151) suggest that immediate instillation is most effective in tumour types with the lowest tendency towards recurrence, i.e., in single primary or small tumours. Mitomycin C, epirubicin, and doxorubicin have all shown a beneficial effect; no ef