T1高危膀胱癌保留膀胱综合治疗方法的疗效评价  

Effects of comprehensive bladder sparing therapy for T1 stage high-risk bladder cancer

作　　者：李志辉[1] 张国辉 关亚伟 滕竞飞 贾卓敏[1] 高峰[1] 艾星 LI Zhihui;ZHANG Guohui;GUAN Yawei;TENG Jingfei;JIA Zhuomin;GAO Feng;AI Xing(Department of Urology,Seventh Medical Center of PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心泌尿外科,北京100700

出　　处：《现代泌尿外科杂志》2021年第6期478-480,共3页Journal of Modern Urology

摘　　要：目的比较经尿道膀胱肿瘤切除术(TURBT)+膀胱灌注化疗+髂内动脉灌注化疗与TURBT+膀胱灌注化疗治疗T1高危膀胱癌的临床疗效。方法回顾性分析2016年2月至2019年5月解放军总医院收治的124例TURBT后诊断为T1高危膀胱癌患者的临床和随访资料。其中综合治疗组46例,应用TURBT+膀胱灌注化疗+髂内动脉灌注化疗方案;对照组78例,应用TURBT+膀胱灌注化疗方案。结果术后平均随访(17±3.2)月:综合治疗组中4例复发(8.7%),其中2例进展为肌层浸润性膀胱癌(4.3%);对照组中47例患者出现复发(60.3%),其中15例进展为肌层浸润性膀胱癌(19.2%),综合治疗组无复发率(91.3%vs.39.7%,P=0.000)、无疾病进展率(95.7%vs.80.8%,P=0.020)明显高于对照组,差异均有统计学意义(P均<0.05)。结论对于T1高危膀胱癌患者,保留膀胱综合治疗方法(TURBT+膀胱灌注化疗+髂内动脉灌注化疗)能有效降低肿瘤复发及进展风险,最大限度避免膀胱全切,提高了患者生活质量。该保留膀胱综合治疗方案值得进一步探讨。Objective To compare the clinical efficacy of transurethral resection of bladder tumor(TURBT)+bladder perfusion chemotherapy+intraarterial chemotherapy(comprehensive treatment)and TURBT+bladder perfusion chemotherapy in the treatment of high-risk T1 bladder cancer.Methods The clinical and follow-up data of 124 patients with T1 stage high-risk bladder cancer treated during Feb.2016 and May 2019 were retrospectively analyzed,including 46 in the comprehensive treatment group and 78 in the control group.Results During the average follow-up of(17±3.2)months,4 patients(8.7%)in the comprehensive treatment group had recurrence,2(4.3%)of whom developed muscular-invasive bladder cancer,and 47 patients(60.3%)in the control group had recurrence,15(19.2%)of whom developed muscular-invasive bladder cancer.The comprehensive treatment group had a higher recurrence-free survival rate(91.3%vs.39.7%,P=0.000),and progression-free survival rate(95.7%vs.80.8%,P=0.020).Conclusion For patients with T1 stage high-risk bladder cancer,the comprehensive treatment can effectively reduce the risk of tumor recurrence and progression,avoid total bladder resection to the maximum extent,and improve patients quality of life.It is worth further exploration.

关 键 词：经尿道膀胱肿瘤切除术 膀胱癌 T1高危 膀胱灌注化疗 髂内动脉灌注化疗 

分 类 号：R737.14[医药卫生—肿瘤]