Abstract:
Metastatic bladder and renal cancers account respectively for 2.1% and 1.8% of cancer deaths worldwide. The advent of immune checkpoint inhibitors has revolutionized the management of metastatic disease, by demonstrating considerable improvements in overall survival. However, despite initial sensitivity to immune checkpoint inhibitors for most patients, both bladder and renal cancer are associated with short progression-free survival and overall survival, raising the need for further strategies to improve their efficacy. Combining systemic therapies with local approaches is a longstanding concept in urological oncology, in clinical settings including both oligometastatic and polymetastatic disease. Radiation therapy has been increasingly studied with either cytoreductive, consolidative, ablative or immune boosting purposes, but the long-term impact of this strategy remains unclear. This review intends to address the impact of radiation therapy with either curative or palliative intent, for synchronous de novo metastatic bladder and renal cancers.
摘要:
转移性膀胱癌和肾癌分别占全球癌症死亡的2.1%和1.8%。免疫检查点抑制剂的出现彻底改变了转移性疾病的管理,通过证明总体生存率的显着改善。然而,尽管大多数患者最初对免疫检查点抑制剂敏感,膀胱癌和肾癌均与短无进展生存期和总生存期相关,提出需要采取进一步的策略来提高其疗效。将全身治疗与局部方法相结合是泌尿外科肿瘤学中一个长期存在的概念。在临床上,包括寡转移和多转移疾病。放射治疗越来越多的研究与细胞还原,合并,消融或免疫增强的目的,但这一战略的长期影响仍不清楚。这篇综述旨在解决具有治愈性或姑息性意图的放射治疗的影响,同步从头转移膀胱癌和肾癌。