摘要
目的:结合文献探讨保留膀胱的局部切除联合髂内动脉插管化疗治疗浸润性膀胱癌的可行性和有效性。方法:对33例不能或不愿接受膀胱全切手术的T_2～T_4浸润性膀胱癌患者,18例术前给予新辅助介入化疗1～3个疗程后给予局部切除,15例在经尿道切除术后,给予辅助介入化疗3次。化疗方案为顺铂80 mg、表柔吡星50 mg以及5氟尿嘧啶1 g(或羟基喜树碱40 mg)。结果:术前新辅助化疗组肿瘤均有不同程度的缩小,完全恢复1例,部分恢复16例,无效1例,平均随访31.6月,1例术后因肿瘤转移死亡,局部复发7例,远处转移2例;术后辅助化疗组,平均随访27个月,术后复发5例,远处转移1例,无死亡病例。结论:联合应用髂内动脉插管化疗结合保留膀胱的局部切除,是治疗浸润性膀胱肿瘤的可选择有效手段,术前确诊的浸润性肿瘤,应选择新辅助介入化疗。
Objective： To evaluate the feasibility and effectiveness of bladder-preserving local resection combined with internal lilac arterial chemotherapy for patients with invasive bladder cancer. Methods： 33 patients who were can not or unwilling to receive radical cystectomy were enrolled in this study. All patients bad muscle invasive transitional cell carcinoma of bladder（T2-4）. 18 patients received bladder presevation resection after -3 courses of neoadjuvant intra arterial chemotherapy. 15 patients treated with 3 courses neoadjuvant intra-arterial chemotherapy after bladder presevation resection. The chemotherapy regimen consisted of cisplatin 80 rag, Epirubicin 50 mg and 5 fluorouracil 1 g/camptothecin 40 mg. Results： All the tumors of preoperative neoadjuvant chemotherapy group had shrinked in various degrees. At the end of neoadjuvant therapy, 1 patient showed a complete response and 16 patients showed partial response; and 1 patient was invalid. With a median follow-up of al. 6 months local recurrence in 7 cases and distant metastasis occured in 2 patients, 1 patient died of distant metastasis. For postop erative neoadjuvant chemotherapy grou, the median follow-up of 27 months. Local recurrence in 5 cases and dis tant metastasis occured in 1 patients. Conclusions： Internal iliac arterial chemotherapy combined with bladder-preserving local resection is a feasible and promising treatment for patients with invasive bladder cancer. The intervene neoadjuvant chemotherapy is a good choose for diagnosed invasive tumor before bladder presevation resection.
出处
《临床泌尿外科杂志》
北大核心
2009年第4期249-251,254,共4页
Journal of Clinical Urology
关键词
膀胱肿瘤
治疗
动脉化疗
手术
bladder tumor
therapy
intra arterialc hemotherapy
surgery
