保留膀胱术后综合治疗肌层浸润性膀胱癌的临床疗效  

Clinical Efficacy of Combination Treatment of Retaining Bladder Operation for Muscle-Invasive Bladder Cancer

作　　者：崔殿生[1] 熊治国[1] 魏少忠[1] 闫玉虎[1] 

机构地区：[1]湖北省肿瘤医院泌尿外科,湖北武汉430070

出　　处：《武汉大学学报（医学版）》2014年第4期606-608,共3页Medical Journal of Wuhan University

摘　　要：目的:探讨保留膀胱术+膀胱内灌注化疗+静脉化疗治疗浸润性膀胱癌的临床疗效及其应用价值。方法:2007年1月-2012年8月期间行经尿道膀胱肿瘤电切术或膀胱部分切除术的25例肌层浸润性膀胱癌(T2-3N0M0)的患者,给予静脉化疗加膀胱灌注化疗,GC化疗方案(吉西他滨1 000mg/m2,第1天,静脉滴注;顺铂70mg/m2,第2-4天,静脉滴注,每3周重复),共4-6个疗程;常规膀胱灌注化疗,药物为吡柔比星。结果:25例例患者均获得随访,随访12-68个月,平均34个月,20例(80%)患者无复发及转移,5例(20%)患者复发,3例复发患者给予全膀胱切除术,2例患者给予介入治疗或放疗,1例患者死亡,化疗副反应均可耐受。结论:保留膀胱手术后确诊的局限性浸润性膀胱癌的患者,采用静脉化疗治疗+膀胱内灌注化疗的联合治疗方法,能明显的提高疗效,有效地减少肿瘤的复发,提高了患者的生活质量,患者易于接受,值得进一步探讨。Objective. To assess the efficacy of retaining bladder operation combined with infusion chem- otherapy and intra-venous chemotherapy in bladder cancer with muscle invasion, and to explore the application value. Methods： From Jan, 2007 to Aug, 2012, 25 patients diagnosed as invasive bladder cancer （T2-3 N0M0） underwent TURBT or partial bladder resection ＋ intra-venous chemotherapy ＋ bladder infusion chemotherapy. GC （Gemcitabine ＋ eisplatin） chemotherapy regimen was adopted for a total of 4-6 courses with conventional bladder irrigation of pirarubicin. Results： All 25 patients were followed up from 12 to 68 months, with an average of 34 months, and 20 （80X） cases survived without relapse or metastasis. Relapse occurred in 5 （20%） cases, of which, 3 cases underwent cystectomy, and the other 2 cases, including one case died, only re- ceived chemotherapy. All cases could tolerate the side effects of chemotherapy well. Conclusion： For the invasive bladder cancer patients after operation, combined treatment of intra-venous chemotherapy ＋ bladder infusion chemotherapy, has good clinical efficacy, could reduce tumor recurrence significantly, and improve the quality of life of patients with good treatment compliance.

关 键 词：浸润性膀胱癌 保留膀胱手术 静脉化疗 膀胱内灌注化疗 

分 类 号：R737.14[医药卫生—肿瘤]