摘要
目的：探讨经尿道膀胱肿瘤电切术（TURBT）联合化疗和放疗的三联疗法对局限性肌层浸润性膀胱癌患者保留器官的可行性。方法回顾性分析2007年11月至2013年6月收治的经TURBT诊断为肌层浸润性膀胱癌107例患者的临床资料。其中行保留膀胱三联治疗者36例（ A组），男28例，女8例，年龄42-88岁，中位年龄69岁。同期行膀胱癌根治术71例（ B组），男54例，女17例，年龄38-77岁，中位年龄66岁。 A组中T2期19例，T3期13例，T4a期4例；TURBT术后行2-3个疗程化疗，后行放疗；11例行吉西他滨联合顺铂静脉化疗，15例行吉西他滨联合顺铂动脉化疗，10例行紫杉醇联合卡铂静脉化疗。 B组中T2期38例，T3期27例，T4a期6例；TURBT术后行膀胱癌根治术。比较两组的疗效。结果 A组共随访3-79个月，T2期无进展生存15例（78．9％），T3期无进展生存6例（46．2％），T4a期无进展生存0例。无疾病复发总体器官保存率达58．3％。随访期间远处转移6例次（16．7％），局部复发11例次（30．6％）。 B组共随访2-65个月，T2期无进展生存29例（76．3％），T3期无进展生存15例（55．6％），T4a期无进展生存1例（16．7％）。无进展生存率达63．4％。随访期间远处转移22例次（31．0％），局部复发16例次（22．5％）。各分期患者的2年无进展生存率两组间比较差异无统计学意义（ P＞0．05）。 A组中，3种化疗方式的疗效差异无统计学意义（P＞0．05）。结论对于局限性肌层浸润性膀胱癌患者行保留膀胱的三联疗法与行膀胱癌根治术比较，2年无进展生存率无明显差异。 T2期保留膀胱的疗效明显优于T3期及T4a期。
Objective To detect the efficacy of trimodality treatment combining transurethral resection of bladder tumor （TURBT）, chemotherapy and radiotherapy for locally muscle-invasive bladder cancer.Methods From November 2007 to June 2013, 107 local muscle-invasive bladder cancer cases were treated by TURBT.Thirty-six cases （ group A） underwent the bladder-sparing trimodality treatment, aged from 42 to 88 years.Seventy -one cases （group B） underwent radical cystectomy,aged from 38 to 77 years.In group A, there were 19 cases of T2 , 13 cases of T3 , and 4 cases of T4a.Among those patients, 11 patients underwent gemcitabine/cisplatin （ GC ） systemic chemotherapy regimen, 15 patients underwent gemcitabine/cisplatin （ GC ） intrailliac artery chemotherapy regimen, and 10 patients underwent taxane/carboplatin （ TC） systemic chemotherapy regimen.In group B, there were 38 cases of T2 , 27 cases of T3 , 6 cases of T4a.The progress-free survival after 2 years was compared with the only radical cystectomy, and the efficacy among the three chemotherapy regimens was also evaluated.Results There is no statistical difference in age and tumor stage between the two groups.In group A, patients were followed up from 3 to 79 months, and 2 years′progress-free survival was 78.9%（15 cases） in T2 , 46.2%（6 cases） in T3 , and 0 in T4a.In group A, organ-sparing 2 years′progress-free survival was 58.3%, and 6 metastasis （16.7%） and 11 local relapse （ 30.6%） were detected during the follow-up period.In group B, patients were followed up from 2 to 65 months, and 2 years′progress-free survival was 76.3%in T2（29 cases）, 55.6%（15 cases） in T3, and 16.7% （1 case） in T4a.Of all the patients in group B, 2 years′progress-free survival was 63.4%, and 22 metastasis （ 31.0%） and 16 local relapse （ 22.5%） were found during the follow-up period.There′s no statistical difference on 2 years′progress-free survival between the two groups, and the efficacy among the three chemotherapy regimens.C
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2016年第2期131-134,共4页
Chinese Journal of Urology
