综合治疗膀胱癌远期疗效分析  

The Long-term Effect in the Syntheszing Treatment of Bladder Cancer

作　　者：周桂霞[1] 张磊[2] 曾狄闻[1] 王晓雄[2] 

机构地区：[1]解放军总医院放疗科,北京市100853 [2]解放军总医院泌尿外科,北京市100853

出　　处：《中国肿瘤临床》2004年第20期1157-1159,1162,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨术后膀胱灌注、加温和放射治疗膀胱癌的综合治疗方案。方法:术后灌注(A)组134例;术后灌注加温(B)组106例;术后灌注放疗(C)组176例。术后3周膀胱内灌注噻替哌50～60mg/次,1～2次/w,共10～12次或丝裂霉素20mg,1次/w,连用6～8次。使用8、10或18MV高能X射线,照射剂量30～60Gy;加温在灌注后1小时内进行,每次30～40分钟。结果:A、B、C组5、10和15年生存率分别为58.2%、58.5%、72.7%;26.9%、27.4%、44.9%和5.9%、8.2%、18.4%;各组T1期与T2和T3期生存率均有显著性差异,字2=6.27,P<0.05。A、B和C组5、10和15年生存者膀胱保留率分别为53.8%、69.4%、81.3%;19.4%、24.1%、51.9%;、0、0和37.5%。结论:术后膀胱灌注加放疗治疗膀胱癌在提高肿瘤局控率、降低盆腔复发率、提高膀胱保存率和远期疗效均明显高于膀胱灌注和灌注加温组。Objective: To evaluate and optimize synthesizing regimen for postoperative bladder cancer. Methods: One hundred and thirty-four patients were treated with intravesical chemotherapy alone, 106 with intravesical chemotherapy plus hyperthermia, 176 with intravesical chemotherapy and radiotherapy post-operatively. The intravesical chemotherapy was given 3 weeks after operation, with thio-TEPA 50~60mg/fraction, using 6 to 8 fractions. For radiotherapy, 8, 10 or 18 MV X-ray was given with total dose of 30~60Gy. Hyperthermia was performed in 1 hour, with intravesical chemotherapy, and each fraction costed about 30 or 40 min. Results: The 5, 10 and 15-year survival rate for group A, B abd C were 58.2%, 58.5% and 72.7%(A), 26.9%, 27.4% and 44.9% (B), and 5.9%, 8.2% and 18.4% (C), respectively. There was significant difference between T1 and T2/T3 stages at each group, P<0.05. The rate of preserving bladder in group A, B and C for 5, 10 and 15 years were 53.8%, 69.4%, and 81.3%(A), 19.4%, 24.1% and 51.9%(B), 0, 0 and 37.5%(C), respectively. Conclusion: The intravesical chemotherapy and radiotherapy for postoperative bladder cancer patients can enhance local control rate, dicrease recurrent rate in pelvic, raise the rate of preversing bladder and improve the long-term survival.

关 键 词：膀胱癌 放射治疗 膀胱灌注 综合治疗 

分 类 号：R737.14[医药卫生—肿瘤]