根治性膀胱切除术长期以来一直被视为治疗局限性肌层浸润性膀胱癌（MIBC）的“黄金标准”，而放射治疗则被限定为那些无法手术治疗或由于其他并发症不能手术切除的患者。尽管大量数据显示这两种治疗方式在这种情况下的生存率相等，但放射治疗作为膀胱保留策略的一部分仍然存在一些常见迷思。我们揭露了无依据的劣质结果和被认为与膀胱保留相矛盾的偏见以及与分段疗法有关的无根据的疑虑。最后，我们警告不要将新辅助化疗的反应作为治疗选择的预测生物标志物，并建议将三联疗法膀胱保留作为一种与根治性膀胱切除术在临床平衡的治疗选择。 © 2022年作者。由Elsevier Inc.发表，保留所有权利。

Radical cystectomy is long considered as the "gold standard" in the management of localized muscle-invasive bladder cancer (MIBC), and curative intent radiotherapy is relegated to those with either inoperable tumors or with multiple co-morbidities precluding surgery. This is despite a large volume of data showing equal survival between the two modalities of treatment in this setting. In this work we seek to dispel some common myths surrounding curative intent radiotherapy as part of a bladder preservation strategy in MIBC. Baseless claims of inferior outcomes and perceived contraindications for bladder preservation are debunked along with unfounded doubts relating to hypofractionation. Finally, we caution against using response to neoadjuvant chemotherapy as a predictive biomarker for treatment selection and conclude by recommending that trimodality bladder preservation be offered as a therapeutic option that is in clinical equipoise with radical cystectomy.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.