Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer
Purpose of the study. Generalization of the world experience of organ‑preserving treatment in muscle‑invasive bladder cancerMaterials and methods. The literature was searched in Medline, Cochrane Library, Elibrary and PubMed systems. Publications describing the modern possibilities of organ‑preservi...
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| Format: | Article |
| Language: | Russian |
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QUASAR, LLC
2023-03-01
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| Series: | Исследования и практика в медицине |
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| Online Access: | https://www.rpmj.ru/rpmj/article/view/864 |
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| author | A. V. Troianov I. O. Dementev I. N. Zaborsky V. S. Chaykov O. B. Karyakin Yu. V. Gumenetskaya |
| author_facet | A. V. Troianov I. O. Dementev I. N. Zaborsky V. S. Chaykov O. B. Karyakin Yu. V. Gumenetskaya |
| author_sort | A. V. Troianov |
| collection | DOAJ |
| description | Purpose of the study. Generalization of the world experience of organ‑preserving treatment in muscle‑invasive bladder cancerMaterials and methods. The literature was searched in Medline, Cochrane Library, Elibrary and PubMed systems. Publications describing the modern possibilities of organ‑preserving treatment of muscle‑invasive bladder cancer were included, 58 of which were used to write this review.Results. The review highlights the results of international randomized and significant non‑randomized studies of organ‑preserving treatment in muscle‑invasive bladder cancer. Special attention is paid to the description of a modern combination of treatment methods to achieve its maximum effectiveness while maintaining the quality of life of patients. The analysis of the world literature was carried out, confirming the prospects of organ‑preserving treatment with careful selection of patients.Conclusion. Organ-preserving trimodal therapy for muscle‑invasive bladder cancer remains an alternative treatment strategy. Careful selection of patients plays a key role. The modern approach to trimodal therapy (TMT) is as follows: complete transurethral resection of the bladder (TURB), neoadjuvant or adjuvant chemotherapy, subsequent assessment of the response to treatment (re‑staging with TURB) should be performed; with a complete pathomorphological response, a course of remote radiation therapy up to TFD 60–66 Gy in the case of traditional fractionation (focal radiation therapy and the use of hypofractionation modes are also possible), using modern irradiation technologies (IGRT, IMRT). In case of an incomplete response, the implementation of the radical cystectomy (RCE) is shown. If a relapse occurs during follow‑up after treatment in the volume of TMT, a life‑saving RCE is shown.If the above conditions are met, the oncological results of treatment with TMT are equivalent to those during RCE, but require further study. |
| format | Article |
| id | doaj-art-e38b07d9e9fa4999ab182ef35c7f00f0 |
| institution | Kabale University |
| issn | 2410-1893 |
| language | Russian |
| publishDate | 2023-03-01 |
| publisher | QUASAR, LLC |
| record_format | Article |
| series | Исследования и практика в медицине |
| spelling | doaj-art-e38b07d9e9fa4999ab182ef35c7f00f02025-02-03T00:57:40ZrusQUASAR, LLCИсследования и практика в медицине2410-18932023-03-0110111112510.17709/2410-1893-2023-10-1-10491Trimodal organ‑preserving treatment of muscle‑invasive bladder cancerA. V. Troianov0I. O. Dementev1I. N. Zaborsky2V. S. Chaykov3O. B. Karyakin4Yu. V. Gumenetskaya5A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian FederationA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian FederationA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian FederationA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian FederationA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian FederationA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian FederationPurpose of the study. Generalization of the world experience of organ‑preserving treatment in muscle‑invasive bladder cancerMaterials and methods. The literature was searched in Medline, Cochrane Library, Elibrary and PubMed systems. Publications describing the modern possibilities of organ‑preserving treatment of muscle‑invasive bladder cancer were included, 58 of which were used to write this review.Results. The review highlights the results of international randomized and significant non‑randomized studies of organ‑preserving treatment in muscle‑invasive bladder cancer. Special attention is paid to the description of a modern combination of treatment methods to achieve its maximum effectiveness while maintaining the quality of life of patients. The analysis of the world literature was carried out, confirming the prospects of organ‑preserving treatment with careful selection of patients.Conclusion. Organ-preserving trimodal therapy for muscle‑invasive bladder cancer remains an alternative treatment strategy. Careful selection of patients plays a key role. The modern approach to trimodal therapy (TMT) is as follows: complete transurethral resection of the bladder (TURB), neoadjuvant or adjuvant chemotherapy, subsequent assessment of the response to treatment (re‑staging with TURB) should be performed; with a complete pathomorphological response, a course of remote radiation therapy up to TFD 60–66 Gy in the case of traditional fractionation (focal radiation therapy and the use of hypofractionation modes are also possible), using modern irradiation technologies (IGRT, IMRT). In case of an incomplete response, the implementation of the radical cystectomy (RCE) is shown. If a relapse occurs during follow‑up after treatment in the volume of TMT, a life‑saving RCE is shown.If the above conditions are met, the oncological results of treatment with TMT are equivalent to those during RCE, but require further study.https://www.rpmj.ru/rpmj/article/view/864muscle-invasive bladder cancerorgan-preserving treatmenttrimodal therapycombined treatment |
| spellingShingle | A. V. Troianov I. O. Dementev I. N. Zaborsky V. S. Chaykov O. B. Karyakin Yu. V. Gumenetskaya Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer Исследования и практика в медицине muscle-invasive bladder cancer organ-preserving treatment trimodal therapy combined treatment |
| title | Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer |
| title_full | Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer |
| title_fullStr | Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer |
| title_full_unstemmed | Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer |
| title_short | Trimodal organ‑preserving treatment of muscle‑invasive bladder cancer |
| title_sort | trimodal organ preserving treatment of muscle invasive bladder cancer |
| topic | muscle-invasive bladder cancer organ-preserving treatment trimodal therapy combined treatment |
| url | https://www.rpmj.ru/rpmj/article/view/864 |
| work_keys_str_mv | AT avtroianov trimodalorganpreservingtreatmentofmuscleinvasivebladdercancer AT iodementev trimodalorganpreservingtreatmentofmuscleinvasivebladdercancer AT inzaborsky trimodalorganpreservingtreatmentofmuscleinvasivebladdercancer AT vschaykov trimodalorganpreservingtreatmentofmuscleinvasivebladdercancer AT obkaryakin trimodalorganpreservingtreatmentofmuscleinvasivebladdercancer AT yuvgumenetskaya trimodalorganpreservingtreatmentofmuscleinvasivebladdercancer |