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blasenerhaltende Therapie des Harnblasen - Karzinoms

Allgemeines

Frühe Stadien werden durch TUR-B exzidiert. Ggf. werden Zytostatika installiert.

Operation

transurethrale Resektion: Stadium Ta, T1, Tis.

blasenerhaltende Therapie

Study (ref) No. of patients Technique 2a-OS 3a-OS 5a-OS 10a-OS 3a-DSS 5a-DSS 10a-DSS 2a-Blasenerhalt 3a-Blasenerhalt 5a-Blasenerhalt 10a-Blasenerhalt
Efstathiou et al (3) 190 Conventional - - 52% 35% - 64% 59% - - 80% -
Rödel et al (4) 326 Conventional - - 45% 29% - 56% 42% - - - 64%
Mak et al (5) 468 Conventional - - 57% 36% - 71% 65% - - 80% -
Huddart et al (6) 108-Standard whole-bladder RT arm 3DCRT - - 38% - - - - 89,8% - - -
111-Reduced high-dose volume RT arm - - 44% - - - - 88,3% - - -
Chung et al (7) 340 Conventional - - 32% 19% - 42% 35% - - 87% -
Baxter et al (8) 50 3DCRT - - 30% 17% - 31% 27% - - 60% -
Lee et al (9) 70 3DCRT followed by IMRT for tumor bed boost - - 50,8 - - 67,3% - - - 61,7% -
Hoskin et al (10) 163-RT - alone arm 3DCRT - 46% - - 43% - - - - - -
164-RT + CON arm - 59% - - 54 - - - - - -
Turgeon et al (11) 24 IMRT - 61% - - 71% - - - 75% - -
Meijer et al (12) 20 Adaptive RT 50% - - - - - - 90% - - -
Present study (13) 44 Adaptive RT - 67% - - 73% - - - 83% - -
Abbreviations: 3DCRT = 3-dimensional conformal RT; CON = carbogen and nicotinamide; IMRT = intensity modulated RT; RTOG = Radiation Therapy Oncology Group.

Quellen

1.) Coppin CM, et al.:
Improved local control of invasive bladder cancer by concurrent cisplatin and preoperative or definitive radiation.
JCO 14(1996):2901-7

2.) Ploussard G, et al.:
Critical analysis of bladder sparing with trimodal therapy in muscle-invasive bladder cancer: a systematic review.
Eur Urol 2014;66:120-37.doi: 10.1016/j.eururo.2014.02.038

3.) Efstathiou JA, Spiegel DY, Shipley WU, et al.:
Long-term outcomes of selective bladder preservation by combined-modality therapy for invasive bladder cancer: The MGH experience.
Eur Urol 2012;61:705-74

4.) Rödel C, Grabenbauer GG, Ku¨hn R, et al.:
Combined-modality treatment and selective organ preservation in invasive bladder cancer: Long-term results.
J Clin Oncol 2002;20:3061-3071

5.) Mak RH, Hunt D, Shipley WU, et al.:
Long-term outcomes in patients with muscle-invasive bladder cancer after selective bladder-preserving combined-modality therapy: A pooled analysis of Radiation Therapy Oncology Group protocols 8802, 8903, 9506, 9706, 9906, and 0233.
J Clin Oncol 2014;32:3801-3809

6.) Huddart RA, Hall E, Hussain SA, et al.:
Randomized non inferiority trial of reduced high-dose volume versus standard volume radiation therapy for muscle-invasive bladder cancer: Results of the BC2001 trial (CRUK/01/004).
Int J Radiat Oncol Biol Phys 206;87:261-269

7.) Chung PWM, Bristow RG, Milosevic MF, et al.:
Long-term outcome of radiation-based conservation therapy for invasive bladder cancer.
Urol Oncol 2007;25:303-309

8.) Baxter E, Dennis K, Kollmannsberger C, et al.:
Radical trimodality therapy for patients with locally advanced bladder cancer: The British Columbia Cancer Agency experience.
Urol Oncol 2015;33:66.e6-66,e19

9.) Lee C, Yang K, Ko H, et al.:
Trimodality bladder-sparing approach without neoadjuvant chemotherapy for node-negative localized muscle-invasive urinary bladder cancer resulted in comparable cystectomy-free survival.
Radiation Oncology 2014;9:1-8

10. Hoskin PJ, Rojas AM, Bentzen SM, et al.:
Radiotherapy with concurrent carbogen and nicotinamide in bladder carcinoma.
J Clin Oncol 2010;28:4912-4918

11. Turgeon G-A, Souhami L, Cury FL, et al.:
Hypofractionated intensity modulated radiation therapy in combined modality treatment for bladder preservation in elderly patients with invasive bladder cancer.
Int J Radiat Oncol Biol Phys 2014;88:326-331

12. Meijer GJ, Van Der Toorn PP, Bal M, et al.:
High precision bladder cancer irradiation by integrating a library planning procedure of 6 prospectively generated SIB IMRT plans with image guidance using lipiodol markers.
Radiother Oncol 2012;105:174-179

13.) Murthy V, et al.:
Clinical Outcomes With Dose-Escalated Adaptive Radiation Therapy for Urinary Bladder Cancer: A Prospective Study.
Int J Radiation Oncol Biol Phys 2016;94,60-66
http://dx.doi.org/10.1016/j.ijrobp.2015.09.010

14.) James ND, Hussain SA, Hall E et al.:
Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer.
N Engl J Med 2012;366:1477–1488

15.) Weiss C, Wittlinger M, Engehausen DG et al.:
Management of superficial recurrences in an irradiated bladder after combined- modality organ-preserving therapy.
Int J Radiat Oncol Biol Phys 2008;70:1502–1506

16.) Zietman AL, Grocela J, Zehr E et al.:
Selective bladder conservation using transurethral resection, chemotherapy, and radiation: management and consequences of Ta, T1, and Tis recurrence within the retained bladder.
Urology 2001;58:380–385

17.) Gray PJ, Fedewa SA, Shipley WU et al.:
Use of potentially curative therapies for muscle-invasive bladder cancer in the United States: results from the national cancer data base.
Eur Urol 2006;63:823–829

18.) Efstathiou JA, Spiegel DY, Shipley WU et al.:
Long-term outcomes of selective bladder preservation by combined-modality therapy for invasive bladder cancer: the MGH experience.
Eur Urol 2012;61:705–74

19.) Shipley WU, Kaufman DS, Zehr E et al.:
Selective bladder preservation by combined modality protocol treatment: long-term outcomes of 190 patients with invasive bladder cancer.
Urology 2002;60:62–67

20.) Krause FS, Walter B, Ott OJ et al.:
15-year survival rates after transurethral resection and radiochemotherapy or radiation in bladder cancer treatment.
Anticancer Res 2004;31:985–990

21.) Dunst J, Sauer R, Schrott KM, et al.:
Organ-sparing treatment of advanced bladder cancer: a 10-year experience.
Int J Radiat Oncol Biol Phys 1994;30:261–266

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Impressum                                 Zuletzt geändert am 16.10.2022 6:08