“三联”保膀胱模式治疗肌层浸润性膀胱癌的疗效观察  

The effect of tri-modality therapy on the treatment of muscle-invasive bladder cancer

作　　者：王建峰[1] 周晓峰[1] 方丹波[2] 吴志明[3] 丁振山[1] 陈星[1] 刘乃波[1] Wang Jianfeng;Zhou Xiaofeng;Fang Danbo;Wu Zhiming;Ding Zhenshan;Chen Xing;Liu Naibo(Department of Urology, China-Japan Friendship Hospital, Beijing 100029, China)

机构地区：[1]中日友好医院泌尿外科,北京100029 [2]浙江大学附属第一医院泌尿外科 [3]中山大学附属肿瘤医院泌尿外科

出　　处：《中华医学杂志》2018年第20期1614-1616,共3页National Medical Journal of China

基　　金：国家国际科技合作专项（2014DFE30010）;国家自然科学基金（81373637）

摘　　要：目的观察根治性经尿道膀胱肿瘤切除术联合术后放化疗的“三联”模式在肌层浸润性膀胱癌（MIBC）保留膀胱治疗上的效果。方法回顾性分析2010年5月至2015年5月中日友好医院等3个中心收治的73例肌层浸润性膀胱癌患者资料。28例患者（TMT组）接受了根治性TURB＋术后联合放化疗。其中男21例，女7例，年龄（68．9±8．9）岁。T2期16例，T3期12例。同期45例患者（RC组）接受了根治性膀胱切除＋尿流改道术，其中男32例，女13例，年龄（66．3±9．6）岁。T2期25例，T3期18例，T4a期2例。分析两种治疗模式对于MIBC预后及生活质量的影响。结果TMT组的总体生存率为64．3％，肿瘤特异性生存率为78．6％。RC的总体生存率为66．7％，肿瘤特异性生存率为82．2％。总体生存时间分别为（47．9±3．2）个月和（48．5±2．6）个月。两组数据比较差异均无统计学意义（均P〉0．05）。术后生活质量评分方面，TMT组优于RC组。结论在严格控制适应证，进行严密的术后随访，并及时进行挽救性膀胱切除术的前提下，“三联”保膀胱疗法可以作为根治性膀胱切除术之外的MIBC患者的一种选择。Objective To explore the effect of radical TURBT combing with concomitant chemoradiotherapy for muscle-invasive bladder cancer （MIBC）. Methods From 2010 to 2015, 73 patients were diagnosed as MIBC, in which 28 patients （TMT Group ） received tri-modality bladder sparing treatment, including 21 males and 7 females, mean age （68.9 ± 8.9） yr. There were 16 cases of T2 , 12 cases of T3. 45 patients （RC Group） received radical cystectomy （RC）, including 32 males and 13 females, mean age （66. 3 ±9. 6） yr. There were 25 cases of T2, 18 cases of T3 and 2 cases of T4a. The effect of two treatment modality and influence for patient＇s life quality were retrospective analysis. Results The overall survival （OS） rate of TMT group was 64. 3% , cancer specific survival （CSS） rate was 78.6%. And the OS rate of RC group was 66. 7% , CSS rate was 82. 2%. There was no statistical difference between two groups. The life quality of TMT group was better than that of RC group. Conclusion In strict control of indication criterion, rigorous postoperative follow-up and timely salvage radical cystectomy, tri-modality therapy can be used as a new option of musele-invasive bladder cancer.

关 键 词：肌层浸润性膀胱癌 保留膀胱 放化疗 

分 类 号：R737.14[医药卫生—肿瘤]