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Neoadjuvant chemotherapy for bladder cancer.

Abstract：

:The 30-45% failure rate after radical cystoprostatectomy mandates that we explore and optimize multimodal therapy to achieve better disease control in these patients. Cisplatin-based multi-agent combination chemotherapy has been used with success in metastatic disease and has therefore also been introduced in patients with high-risk but non-metastatic bladder cancer. There is now convincing evidence that chemotherapy given pre-operatively can improve survival in these patients. In this review we establish the need for peri-operative chemotherapy in bladder cancer patients and summarize the evidence for the efficacy of neoadjuvant chemotherapy. The advantages and disadvantages of neoadjuvant versus adjuvant chemotherapy are discussed, and the main shortcomings of both--treatment-related toxicity and the inability to prospectively identify likely responders--are presented. Finally, a risk-adapted approach to neoadjuvant chemotherapy is presented, whereby the highest risk patients are offered treatment while those unlikely to benefit are spared the treatment-related toxicity.

journal_name

World J Urol

journal_title

World journal of urology

authors

Black PC,Brown GA,Grossman HB,Dinney CP

doi

10.1007/s00345-006-0113-z

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

531-42

issue

5

eissn

0724-4983

issn

1433-8726

journal_volume

24

pub_type

杂志文章,评审

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