Background/Objectives:Penile squamous cell carcinoma (PSCC) is rare but aggressive. Systemic chemotherapy plays a crucial role in the management of node-positive or metastatic cases; however, the supporting evidence predominantly originates from small, non-randomized studies. This review provides a narrative analysis of the cytotoxic classes and regimens employed in PSCC and compares major clinical guidelines to facilitate informed decision-making in practice.Methods:English-language reports were identified in PubMed/Scopus/Google Scholar without date limits. Selection prioritized objective response, survival and toxicity outcomes, and guidance statements across neoadjuvant, adjuvant, and palliative settings.Results:Bleomycin-containing triplet regimens demonstrated efficacy but were associated with unacceptable pulmonary toxicity, leading to their discontinuation in clinical recommendations. Currently, cisplatin/taxane-based combinations remain fundamental in treatment protocols. The paclitaxel–ifosfamide–cisplatin (TIP) regimen achieves approximately 40–50% objective responses in phase II studies and may enable curative surgery, while taxane–cisplatin–5-fluorouracil (TPF) shows comparable efficacy with higher toxicity. For less fit patients, cisplatin–5-fluorouracil (PF) or carboplatin–taxane doublets are pragmatic alternatives. Single-agent taxanes or vinflunine offer modest second-line benefits. Although EAU–ASCO 2023, ESMO–EURACAN 2024, and NCCN v2.2025 are broadly in consensus, recommendations differ regarding eligibility thresholds and regimen preferences. Overall, the quality of the evidence remains low.Conclusions:TIP remains the reference neoadjuvant option for chemotherapy-fit patients with bulky nodal disease; doublets are reasonable when cisplatin fitness is limited; and bleomycin should be avoided. Harmonized eligibility criteria, biomarker-enriched studies, and coordinated multicenter trials are needed to improve outcomes in this rare malignancy.
背景/目的：阴茎鳞状细胞癌（PSCC）虽属罕见但侵袭性强。系统性化疗在淋巴结阳性或转移性病例的治疗中起关键作用，但现有证据主要来源于小规模非随机研究。本综述对PSCC治疗中使用的细胞毒性药物类别及方案进行叙述性分析，并通过对比主要临床指南为临床决策提供参考。 方法：在PubMed/Scopus/Google Scholar数据库中无时间限制检索英文文献。筛选重点聚焦于新辅助、辅助及姑息治疗场景下的客观缓解率、生存结局、毒性反应数据及指南声明。 结果：含博来霉素的三联方案虽显示疗效，但因存在不可接受的肺毒性已从临床推荐中撤出。目前以顺铂/紫杉烷类为基础的联合方案仍是治疗核心。紫杉醇-异环磷酰胺-顺铂（TIP）方案在II期研究中实现约40-50%的客观缓解率，可能为根治性手术创造条件；而紫杉烷-顺铂-5-氟尿嘧啶（TPF）方案虽疗效相当但毒性更高。对于体能状态较差者，顺铂-5-氟尿嘧啶（PF）或卡铂-紫杉烷类双药方案是实用选择。单药紫杉烷类或长春氟宁在二线治疗中获益有限。尽管EAU–ASCO 2023、ESMO–EURACAN 2024与NCCN v2.2025指南总体共识度高，但在适用标准阈值和方案偏好方面仍存差异。总体而言，证据质量仍处于较低水平。 结论：对于体能适合化疗的巨块型淋巴结转移患者，TIP仍是新辅助治疗的基准方案；当顺铂适用性受限时双药方案是合理选择；博来霉素应避免使用。未来需通过统一适用标准、开展生物标志物富集研究及协调多中心临床试验来改善这一罕见恶性肿瘤的治疗结局。
肿瘤(癌症)患者之家