摘要
目的利用BR-TRGY-I型体腔热灌注治疗系统，探讨丝裂霉素（MMC）膀胱腔内热灌注化疗（Hyperthermic Intravesical Chemotherapy，HIVEC）治疗复发浅表性膀胱移行癌（Transitional Cell Carcinoma，TCC）的近期有效性及毒副作用。方法表浅性TCC患者40例，其中初发10例，复发30例，复发次数1～6次，平均2．8次；最后一次复发时间间隔3～32月，平均14．6月，中位时间16月；最后一次复发肿瘤个数为1～20个，平均2．1个。入院后先行经尿道膀胱肿瘤电切术（Transurethral Resection of Bladder Tumor，TURBT），术后3天行MMC的HIVEC。治疗前后复查血常规、肝肾功能，术后随访检查肿瘤有无复发转移。结果治疗过程顺利，6例（15％）诉尿频、尿急、尿痛，治疗后3天～2周症状消失，无明显胃肠道反应、肝肾功能损害、骨髓抑制的发生；随访平均13月（6—40月），膀胱粘膜正常，无肾积水发生，局部复发6例（15％），复发时间6～12月，平均10月，复发个数1～4个，平均2．3个，复发后手术治疗无瘤存活至今。患者治疗后的复发时间间隔较治疗前显著延长，复发个数较治疗前显著减少（P〈0．01）。结论对于复发性TCC患者，MMC行HIVEC是一种安全、有效的治疗方法，该治疗可以增强MMC治疗TCC的临床效果。
Objective To investigate the efficacy and side effect of hyperthermic intravesical chemotherapy （HIVEC） with mitomycin C （MMC） as an adjuvant therapy, after complete transurethral resection （TURBT） of recurrent superficial transitional cell carcinoma （TCC） of the bladder. Methods 40 patients were enrolled, 10 cases of incipience and 30 cases of relapses. These patients suffered from recurrent superficial （Ta- T1） TCC of the bladder, after a complete TURBT, were assigned to receive HIVEC with MMC. A new system, BR-TRGY-I was used. The goal temperature was setting at 45 ~C. The drug solution consisted of 80 mg MMC dissolved in 600 ml of normal saline, was constantly pumped into the bladder with 150 ml/min. The treatment was concluded after a total period of 45 minutes of effective heating （mean inflow solution temperature greater than 43 ℃ ）. During the 45 minutes perfusion, patients＇ vital parameters and the temperature of the drug solution were monitors. HIVEC was administered in four 3-day cycles. The follow-up protocol consisted of cystoscopy every 3 months thereafter. Results The combined chemo-thermotherapy was tolerated relatively well. The most common complication was bladder irritability （15%）, but it was minor in most cases. After a mean follow- up of 20 months, 55% of these patients were recurrence free. 6 cases of （15%） recurrence were seen in a mean period of 10 months in these patients and were treated with TURBT. No disease-related mortality had occurred. Conclusion For patients with recurrent superficial TCC of the bladder, HIVEC is an effective and safe adjuvant treatment method.
出处
《国际医药卫生导报》
2016年第3期303-306,共4页
International Medicine and Health Guidance News
关键词
膀胱癌
局部热疗
化疗
Bladder cancer
Local hyperthermia
Chemotherapy
