髂内动脉化疗栓塞联合鸦胆子油乳术前膀胱灌注对膀胱癌疗效观察  

Preoperative Chemoembolization through Internal Iliac Artery Combined with Intravesical Instillation of Brucea Javanica Oil Emulsion for Invasive Bladder Cancer

作　　者：李永光[1] 陈树山[1] 吴楠[1] 李建新[1] 

机构地区：[1]唐山市中医医院泌尿外科,河北唐山063000

出　　处：《中国慢性病预防与控制》2009年第4期365-367,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的观察骼内动脉化疗栓塞联合鸦胆子油乳术前膀胱灌注治疗浸润性膀胱癌的临床疗效。方法59例浸润性膀胱癌患者随机分为单纯骼内动脉(吉西他滨、顺铂)化疗栓塞组(n=27)及合并鸦胆子油乳术前膀胱灌注组(n=32),采用χ2检验比较两组膀胱保留率、5a复发率,Kaplan-Meier法计算5a总生存率并绘制生存曲线,Log-Rank检验进行两组间生存曲线比较。结果单纯髂内动脉化疗组膀胱保留率63.0%,术后1～、2～、3～、5a～复发率分别为14.8%,25.9%,40.7%,51.9%,5a总生存率39.4%。髂内动脉化疗并鸦胆子组膀胱保留率87.5%,术后1～、2～、3～、5a～复发率分别为9.4%,15.6%,28.1%,40.6%,5a总生存率69.1%。两组间膀胱保留率、5a复发率、5a总生存率差别均有统计学意义(χ2值分别为4.872,4.800,4.188,P<0.05)。结论髂内动脉化疗栓塞联合鸦胆子油乳术前膀胱灌注治疗浸润性膀胱癌疗效较好。Objective To observe clinical effects of preoperative chemoembolization through internal ihac artery combined with Intravesical Instillation of brucea javaniea oil emulsion for invasive bladder cancer. Methods 59 patients with invasive bladder cancer were randomly divided into the chemoembolization group （n=27, treated with chemotherapy infusion of Gemcitabine and Cisplatin through internal iliac artery） and the combined treatment group （n=32, treated by the chemoembolization combined with preoperative intravesical instillation of brucea javanica oil emulsion）. Bladder preserving rate and relapsing rate within 5 - years were tested by ehi-sqnare test; overall survival rate within 5 years was calculated by Kaplan-Meier method and the survival curve was drawn and tested by Log-Rank test. Results Bladder preserving rate was 63.0% in the chemoembolization group, the 1-, 2-, 3-, 5- year relapsing rates were 14.8%, 25.9%, 40.7%, 51.9%, respectively, and overall survival rate within 5-years was 39.4%. Bladder preserving rate was 88.9% in the combined treatment group, the 1-, 2-, 3 -, 5- year relapsing rates were 9.4%, 15.6%, 28.1%, 40.6%, respectively, and the overall survival rate within 5-years was 69.1%. There were significant differences in bladder preserving rate （χ^2=-4.872, P=0.027）, relapsing rate within 5-years （χ^2=4.8, P=0.028）, and the overall survival rate within 5-years（χ^2=4.188, P=0.041 ）between two groups. Conclusion Preoperative chemoembelization through internal lilac artery combined with Intravesical Instillation of brucea javanica oil emulsion has good effect on invasive bladder cancer with fewer side effects.

关 键 词：浸润性膀胱癌 髂内动脉化疗 栓塞 鸦胆子油乳 膀胱灌注 

分 类 号：R737.14[医药卫生—肿瘤]