肌层浸润性膀胱癌保留膀胱综合治疗的疗效评价研究  

The efficacy of comprehensive bladder preservation therapy for muscle-invasive bladder cancer

作　　者：张国辉[1] 王占国 李志辉[1] 郑清友[1] 关亚伟[1] 滕竞飞[1] 贾卓敏[1] 

机构地区：[1]北京军区总医院泌尿外科,北京10070 [2]河北省围场县县医院外科,河北承德068450

出　　处：《癌症进展》2016年第2期102-105,共4页Oncology Progress

摘　　要：目的评价髂内动脉灌注化疗+经尿道膀胱肿瘤电切术+膀胱内灌注化疗综合治疗肌层浸润性膀胱癌的临床疗效。方法比较64例采用髂内动脉灌注化疗(吡柔比星40 mg/m2、5-FU 1000 mg/m2、羟喜树碱30 mg/m2)+经尿道膀胱肿瘤电切术+膀胱内灌注化疗(综合治疗组)和62例采用经尿道膀胱肿瘤电切术+膀胱内灌注化疗(对照组)的肌层浸润性膀胱癌(T2N0M0期)患者经治疗后的肿瘤复发/转移率、死亡率及治疗相关不良反应的发生情况。结果至随访截至日期,综合治疗组的无复发/转移率为93.75%(60/64),明显高于对照组的45.16%(28/62),差异有统计学意义(P=0);转移死亡率为3.13%(2/64),低于对照组的16.13%(10/62),差异有统计学意义(P=0.015);非膀胱癌死亡率为10.94%(7/64),与对照组的12.90%(8/62)相比,差异无统计学意义(P﹥0.05)。结论髂内动脉灌注化疗+经尿道膀胱肿瘤电切术+膀胱内灌注化疗的综合治疗方案,能够降低肌层浸润性膀胱癌(T2N0M0)患者肿瘤复发率和死亡率,不增加非癌性死亡风险,值得进一步探讨。Objective To investigate the clinical efficacy of the comprehensive therapy consisting of iliac artery infusion chemotherapy, transurethral resection of bladder tumor （TUR-BT） and bladder perfusion chemotherapy for muscle- invasive bladder cancer. Method Patients with muscle-invasive bladder cancer （stage T2N0M0） were divided into two groups according to the treatment they had used, with 64 cases treated by iliac artery infusion chemotherapy （Pirarubicin 40 mg/m^2, 5-FU 1000 mg/m^2, hydroxyamptothecin 30 mg/m^2）, TUR-BT and bladder perfusion chemotherapy into compre- hensive therapy group, 62 cases treated by TUR-BT and bladder perfusion chemotherapy into control group, and the tumor recurrence / metastasis, mortality and treatment-related adverse reactions after treatment were compared between two groups. Result As of the end of follow-up, 93.75% （60/64） of the patients in the comprehensive therapy group showed neither recurrence nor metastasis, higher than 45.16% （28/62） in the control group, with statistically significant inter- group differences observed （P=0）. 3.13% （2/64） of the patients in the comprehensive therapy group died of metastasis, significantly lower than 16.13% （10/62） in the control group （P=0.015）. The non-bladder cancer mortality was 10.94% （7/ 64） vs 12.90% （8/62） in comprehensive therapy group vs control group, with no significant difference observed （P〉0.05）. Conclusion The comprehensive therapy consisting of iliac artery infusion chemotherapy, TUR-BT and bladder perfusion chemotherapy can reduce tumor recurrence and mortality in patients with muscle-invasive bladder cancer （T2N0M0）, without risk of increasing non-cancer death, so it＇ s a regimen worth fu^her investigation.

关 键 词：肌层浸润性膀胱癌 髂内动脉灌注化疗 经尿道膀胱肿瘤电切术 膀胱内灌注化疗 

分 类 号：R737.14[医药卫生—肿瘤]