摘要
目的探讨经动脉导管化疗联合膀胱灌注化疗在T1G3膀胱癌保留膀胱术后的辅助治疗价值。方法回顾性分析74例接受保留膀胱术的T1G3膀胱尿路上皮癌患者资料，其中经动脉导管化疗联合膀胱灌注化疗组22例（A组）和单纯膀胱灌注化疗组52例（B组），两组患者性别、年龄、肿瘤大小、个数及肿瘤是否初发差异均无统计学意义（P〉0．05）。A组患者在保留膀胱术后2～3周接受经动脉化疗，方案为吡柔比星／表柔比星40～60mg＋顺铂60～80mg，间隔4～6周重复1次，每3次为1个疗程；两组患者采用相同膀胱灌注化疗方案。中位随访时间为32个月，统计分析比较两组术后的肿瘤特异病死率、复发率、进展率及复发间隔，同时评价经动脉导管化疗的不良反应。结果A、B组术后肿瘤特异病死率分别为0％（0／22）和13．5％（7／52），差异无统计学意义（P=0．096）；复发率分别为13．6％（3／22）和46．2％（24／52），进展率分别为O％（0／22）和21．2％（11／52），差异均有统计学意义（P=0．000，P=0．048）。两组肿瘤中位复发间隔分别为15个月和6．5个月。A组出现轻微恶心、呕吐12例，白细胞下降2例，粒细胞下降2例，肝功能损害4例，肾功能损害1例，所有损害均轻微、可逆。结论经动脉导管化疗联合膀胱灌注化疗可能有助于T1G3期膀胱癌患者保留膀胱术后预防肿瘤复发、进展和延长患者生存，其不良反应较轻，可用于T1G3期膀胱癌患者保留膀胱术后的辅助治疗。
Objective To evaluate the clinical effect of post bladder sparing surgery intra-arterial chemotherapy combined with intravesieal chemotherapy for the treatment of T1G3 bladder urothelial carcinoma. Methods Seventy-four T1G3 bladder cancer patients were enrolled in this study. After bladder sparing surgery, 22 patients received intra-arterial chemotherapy combined with intravesical chemotherapy, while the other 52 patients were treated with intravesical chemotherapy only. There was no significant difference between the 2 groups in sex, age, the size and number of bladder tumor and newly diagnosed cases （P 〉 0.05）. Twenty-two patients were treated with intra-arterial chemotherapy of piarubicin or epirubicin （40 - 60 mg） ＋ cisplatin （60 -80 mg） 2 or 3 weeks after bladder sparing surgery, 3 times as a cycle, repeat every 4 - 6 weeks. All the patients received the same protocol of intravesical chemotherapy. With a median follow-up of 32 months, effects of combination therapy group were compared with intravesical chemotherapy group in the aspects of tumor-specific death rates, recurrent rate, progressive rate, recurrent interval and the adverse reactions. Results The tumor-specific death rates of combination therapy group and intravesical chemotherapy group were 0% （0/22） and 13.5% （7/52） , respectively. There was no difference between the 2 groups （P =0.096）. The recurrent rates were 13.6% （3/22） and 46.2% （24/52） ;The progressive rates were 0% （0/22） and 21.2% （11/52）. There were significant differences between the 2 groups in recurrent rate （ P = 0. 000） and progressive rate （ P = 0. 048 ）. The recurrent intervals of the 2 groups were 15 months and 6.5 months. During the interval of intra-arterial chemotherapy cycle, 12 patients suffered 1 - 2 degree nausea and vomit, 2 patients suffered hypoleukemia, 2 patients suffered neutropenia, 4 patients＇ liver function was impaired and 1 patient＇s renal function was impaired. All the adverse reaetions were minimal and r
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2012年第2期99-103,共5页
Chinese Journal of Urology
关键词
膀胱肿瘤
癌
肿瘤分期
药物疗法
联合
动脉导管化疗
Urinary bladder neoplasms
Carcinoma
Neoplasms staging
Drug therapy, combination
lntra-arterial chemotherapy
