azoxystrobin and Urinary-Bladder-Neoplasms

To investigate the safety and efficacy of "quadri-combination" therapy including maximal transurethral resection of bladder tumor (mTURBT), combined with systemic chemotherapy and immunotherapy, concurrent radiotherapy, and immune maintenance therapy. The clinical data of 8 patients with bladder cancer who could not tolerate or refused radical cystectomy at the Department of Urology, Peking University Cancer Hospital from November 2019 to October 2021 were retrospectively analyzed. There were 5 males and 3 females with a mean age of 69 years. The Eastern Cooperative Oncology Group(ECOG) score was 0 in 6 cases and 1 in 2 cases. There were 5 cases of high-grade urothelial carcinoma (1 case of T3b; 2 cases were T2; 2 cases of T1 stage, with multiple tumors and repeated recurrence), 1 case of high-grade urothelial carcinoma with carcinoma in situ (T1/Tis stage), 1 case of high-grade urothelial carcinoma with squamous differentiation (T3b stage), and 1 case of high-grade urothelial carcinoma with glandular differentiation (T2). All patients underwent "quadri-combination" therapy.The patient's tolerance, success rate of bladder preservation and prognosis were evaluated.The median follow-up time was 22.5 (12-35) months. One patient with high-grade muscle-invasive bladder cancer (T2) received mTURBT, albumin-bound paclitaxel and durvalumab combined therapy for 3 cycles, concurrent radiotherapy, and immune maintenance therapy for 18 months, and the tumor recurrence was found. The pathology was high-grade urothelial carcinoma. Salvage radical cystectomy combined with pelvic lymph node dissection is recommended. The remaining 7 patients were regularly reexamined, and no recurrence or metastasis was found.The 2-year progression-free survival rate was 80%, and the success rate of bladder preservation was 87.5%(7/8). Treatment-related adverse reactions were resolved by symptomatic treatment, and patients' compliance and tolerance were acceptable.The "quadri-combination" bladder-preserving therapy is feasible and well tolerated, but further studies are needed.. 探讨经尿道最大化膀胱肿瘤电切术（mTURBT），联合化疗和免疫治疗，同步放疗以及免疫维持治疗的“四联”保膀胱模式的安全性和疗效。回顾性分析2019年11月至2021年10月北京大学肿瘤医院泌尿外科收治的8例不耐受或拒绝膀胱根治性切除的膀胱癌患者资料。男5例，女3例，平均年龄69（42~83）岁。美国东部肿瘤协作组（ECOG）评分6例0分，2例1分。单纯高级别尿路上皮癌5例（1例T3b期；2例T2期；2例T1期，肿瘤多发且反复复发）；高级别尿路上皮癌合并原位癌1例（T1/Tis期）；高级别尿路上皮癌伴鳞状分化1例（T3b期）；高级别尿路上皮癌伴腺样分化1例（T2期）。患者均行“四联”保膀胱治疗模式。随访评估患者耐受性、保留膀胱成功率及预后情况。中位随访22.5（12~35）个月。1例膀胱单纯高级别尿路上皮癌（T2）患者，接受mTURBT、白蛋白紫杉醇+度伐利尤单抗联合治疗3周期、同步放疗和单药免疫维持保膀胱治疗18个月，复查发现肿瘤复发，病理为高级别尿路上皮癌。余7例患者定期规律复查，未见膀胱肿瘤复发或转移。患者2年无进展生存率为80%，保留膀胱成功率为87.5%（7/8），治疗相关不良反应经对症处理好转，患者依从性及耐受性良好。“四联”保膀胱综合治疗具有可行性，总体疗效和耐受性良好，但仍需进一步研究评估。.

Topics: Aged; Carcinoma, Transitional Cell; Cystectomy; Female; Humans; Male; Neoplasm Recurrence, Local; Retrospective Studies; Urinary Bladder Neoplasms