英国癌症研究所发现,肾盂输尿管切除术后90天内实施吉西他滨-铂联合化疗,可延长局部晚期上尿路癌(UTUC)[1]患者的无病生存期。第三期POUT试验(NCT01993979)随机261例输尿管输尿管切除术后患者接受监测或接受4次21天周期的辅助化疗。对于化疗组的参与者,手术后90天内开始治疗,包括吉西他滨-顺铂或肾功能受损患者吉西他滨-卡铂的联合治疗。在两组治疗组中监测复发迹象的随访频率相同;即4周、7周、10周、13周,对应每个化疗周期结束。患者在每次随访中均接受影像学检查和膀胱镜检查。3年无病生存期包括主要终点;总生存期(OS)和患者报告的生活质量是关键的次要终点。在中位随访48.1个月时,监测组129例患者中有52例(40.3%)死亡,化疗组131例患者中有41例(31.3%)死亡。研究人员报告,化疗组的3年无病生存率为71%,监测组为46%;化疗组的3年生存率为79%,监测组为67%。 In the chemotherapy group, 44% of participants experienced grade ≥3 treatment-emergent adverse events, as compared with only 4% of participants in the surveillance group. These adverse events were consistent with those previously reported for this chemotherapy protocol. Chemotherapy did not have any long-term toxicity associated with it. There were no differences in quality of life outcomes between the groups. The improved DFS outcomes achieved by patients treated with platinum-based chemotherapy within 90 days post-nephroureterectomy have prompted researchers to recommend this protocol be considered a new standard of care for these UTUC patients [2].

  1. Birtle AJ。POUT的最新结果:一项围手术期化疗与上尿路上皮癌(UTUC)监测的III期随机试验。ASCO泌尿生殖系统癌症研讨会,2021年2月11-13日。
  2. Birtle A等。柳叶刀。2020年4月18日;395(10232):1268-1277。