Blasenerhaltende multimodale Therapiekonzepte

In deutschen und internationalen Leitlinien wird die organerhaltende Behandlung des muskelinvasiven Harnblasenkarzinoms für geeignete Patient*innen als onkologisch gleichwertige therapeutische Alternative zur radikalen Zystektomie deklariert. Aktuelle, hochrangig publizierte Daten beschreiben für die multimodale Therapie im Vergleich zur Operation einen Vorteil im Gesamtüberleben.

Schlüsselwörter

simultane Radiochemotherapie - multimodale blasenerhaltende Therapiekonzepte

Publikationsverlauf

Artikel online veröffentlicht:
05. März 2024

• Literatur

• 1 Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. Atlas der Krebsinzidenz und -mortalität in Deutschland (GEKID-Atlas). http://www.gekid.de
• 2 Moll F. Anfänge der modernen Urochirurgie im 19. Jahrhundert. In: Schultheiss D, Rathert P, Jonas U. Streiflichter aus der Geschichte der Urologie. Berlin, Heidelberg, Deutschland: Springer Verlag; 2000
• 3 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms, Langversion 2.0, 2020, AWMF-Registrierungsnummer 032/038OL. https://www.leitlinienprogramm-onkologie.de/leitlinien/harnblasenkarzinom/
• 4 Choudhury A, Porta N, Hall E. et al. Hypofractionated radiotherapy in locally advanced bladder cancer: an individual patient data meta-analysis of the BC2001 and BCON trials. The lancet oncology 2021; 22: 246-255
• 5 Ott OJ, Gaipl US, Lamrani A. et al. The Emerging Evidence Supporting Integration of Deep Regional Hyperthermia With Chemoradiation in Bladder Cancer. Semin Radiat Oncol 2023; 33: 82-90
• 6 Huddart RA, Hall E, Hussain SA. et al. Randomized noninferiority 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 2013; 87: 261-269
• 7 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 2011; 31: 985-990
• 8 James ND, Hussain SA, Hall E. et al. Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. The New England journal of medicine 2012; 366: 1477-1488
• 9 Hall E, Hussain SA, Porta N. et al. Chemoradiotherapy in Muscle-invasive Bladder Cancer: 10-yr Follow-up of the Phase 3 Randomised Controlled BC2001 Trial. European urology 2022; 82: 273-279
• 10 Ott OJ, Rodel C, Weiss C. et al. Radiochemotherapy for bladder cancer. Clin Oncol (R Coll Radiol) 2009; 21: 557-565
• 11 van der Zee J, Gonzalez Gonzalez D, van Rhoon GC. et al. Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial. Dutch Deep Hyperthermia Group. Lancet 2000; 355: 1119-1125
• 12 Wittlinger M, Rodel CM, Weiss C. et al. Quadrimodal treatment of high-risk T1 and T2 bladder cancer: transurethral tumor resection followed by concurrent radiochemotherapy and regional deep hyperthermia. Radiother Oncol 2009; 93: 358-363
• 13 Merten R, Ott O, Haderlein M. et al. Long-Term Experience of Chemoradiotherapy Combined with Deep Regional Hyperthermia for Organ Preservation in High-Risk Bladder Cancer (Ta, Tis, T1, T2). Oncologist 2019; 24: e1341-e1350
• 14 Huddart RA, Hall E, Lewis R. et al. Life and death of spare (selective bladder preservation against radical excision): reflections on why the spare trial closed. BJU international 2010; 106: 753-755
• 15 Kotwal S, Choudhury A, Johnston C. et al. Similar treatment outcomes for radical cystectomy and radical radiotherapy in invasive bladder cancer treated at a United Kingdom specialist treatment center. Int J Radiat Oncol Biol Phys 2008; 70: 456-463
• 16 Munro NP, Sundaram SK, Weston PM. et al. A 10-year retrospective review of a nonrandomized cohort of 458 patients undergoing radical radiotherapy or cystectomy in Yorkshire, UK. Int J Radiat Oncol Biol Phys 2010; 77: 119-124
• 17 Booth CM, Siemens DR, Li G. et al. Curative therapy for bladder cancer in routine clinical practice: a population-based outcomes study. Clin Oncol (R Coll Radiol) 2014; 26: 506-514
• 18 Cahn DB, Handorf EA, Ghiraldi EM. et al. Contemporary use trends and survival outcomes in patients undergoing radical cystectomy or bladder-preservation therapy for muscle-invasive bladder cancer. Cancer 2017; 123: 4337-4345
• 19 Bekelman JE, Handorf EA, Guzzo T. et al. Radical cystectomy versus bladder-preserving therapy for muscle-invasive urothelial carcinoma: examining confounding and misclassification biasin cancer observational comparative effectiveness research. Value Health 2013; 16: 610-618
• 20 Arcangeli G, Strigari L, Arcangeli S. Radical cystectomy versus organ-sparing trimodality treatment in muscle-invasive bladder cancer: A systematic review of clinical trials. Crit Rev Oncol Hematol 2015; 95: 387-396
• 21 Zlotta AR, Ballas LK, Niemierko A. et al. Radical cystectomy versus trimodality therapy for muscle-invasive bladder cancer: a multi-institutional propensity score matched and weighted analysis. The lancet oncology 2023; 24: 669-681