首页膀胱肿瘤治疗及预后证据详情

Perioperative outcomes of intracorporeal robot-assisted radical cystectomy versus open radical cystectomy: A systematic review and meta-analysis of comparative studies

原文: 2021 年 发布于 Eur Urol Oncol 13 卷 第 7 期 180-190 浏览量:270次

作者: Zhou N. Tian F. Feng Y. Zhao K. Chen L. Fan R. Lu W. Gu C.

作者单位: 天津市西青医院泌尿外科 天津市西青医院胸外科 天津市西青医院急创中心

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.3390/cancers15071937

关键词: alcohol bladder cancer dose-response meta-analysis systematic review commercial or financial relationships that could be construed as a potential conflict of interest.

文献简介

BACKGROUND/PURPOSE: The optimal dose fractionation for palliative radiotherapy (RT) in patients with symptomatic advanced bladder cancer is unclear. This study aimed to determine if a higher dose of RT was associated with improved symptoms response rates. METHODS: We searched PubMed, Central and Embase for eligible studies published from 1990 to 2019. The primary outcomes were symptoms response rates for hematuria, dysuria and frequency. Secondary outcomes included treatment-related adverse events and quality of life. RESULTS: We found one randomized, four prospective and eight retrospective non-comparative observational studies including 1320 patients who received palliative bladder radiotherapy for symptom relief. The dose fractionation schedules varied across studies ranging from 8 Gy single fraction to 60 Gy in 2 to 8 Gy per fraction. The pooled response rates for hematuria, dyuria and frequency symptoms were 74%, 58% and 71% respectively. A higher dose of RT was not associated with improved response rates of hematuria and frequency. However, a higher dose of RT was associated with a longer duration of hematuria response and reduced response of dysuria. Grade 3 gastrointestinal and genitourinary toxicity occurred in up to 26% of patients. Health-related quality of life (HRQOL) outcomes were reported in one study. CONCLUSION: This systematic review demonstrates that a higher dose of bladder RT was not associated with improved response rates of hematuria and frequency symptoms but was associated with reduced response of dysuria. Higher doses of bladder RT was associated with more durable hematuria response. Prospective studies to determine the effects of palliative bladder radiotherapy on HRQOL outcomes are warranted.

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