Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press30810.17650/1726-9776-2010-6-3-51-56REVIEWОБЗОРTREATMENT IN PATIENTS WITH MUSCLE NONINVASIVE CARCINOMA OF THE URINARY BLADDER AFTER UNSUCCESSFUL INTRAVESICULAR BCG THERAPYЛЕЧЕНИЕ БОЛЬНЫХ МЫШЕЧНО-НЕИНВАЗИВНЫМ РАКОМ МОЧЕВОГО ПУЗЫРЯ ПОСЛЕ НЕУДАЧНОГО ПРИМЕНЕНИЯ ВНУТРИПУЗЫРНОЙ БЦЖ-ТЕРАПИИFigurinK. M.ФигуринК. М.
Russian Federation
kfigurin@mail.ruN.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowГУ РОНЦ им. Н.Н. Блохина РАМН, Москва3009201063515605082014https://oncourology.abvpress.ru/oncur/article/view/308

Failures of BCG therapy for muscle noninvasive carcinoma of the urinary bladder are classified as BCG refractoriness, BCG resistance, postBCG-therapy recurrences. Some patients are observed to be BCG intolerant, which makes the therapy discontinued. Detectable BCG refractoriness and early recurrences are associated with a high risk of progression and high tumor-specific mortality and are indications for emergency cystectomy. Preference should be given to early cystectomy if high risk group patients have additional poor prognostic factors for disease progression. In patients with BCG therapy failures, medical treatment should be performed only within research programs.

Неудачи БЦЖ-терапии мышечно-неинвазивного рака мочевого пузыря классифицируются как БЦЖ-рефрактерность, БЦЖ- резистентность, рецидивы после БЦЖ-терапии. У части больных отмечается непереносимость БЦЖ, в связи с чем лечение приходится прекращать. Выявляемые у пациентов БЦЖ-рефрактерность, ранние рецидивы заболевания ассоциируются с высоким риском прогрессии, высокой опухолеспецифической смертностью и являются показаниями к выполнению немедленной цистэктомии. При наличии у больных группы высокого риска дополнительных неблагоприятных прогностических факторов прогрессии заболевания следует отдать предпочтение ранней цистэктомии. Консервативное лечение больных с неудачами БЦЖ-терапии может проводиться только в рамках исследовательских программ.

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