载药微球栓塞治疗膀胱癌伴出血16例  

Drug-eluting beads embolization for the treatment of bladder cancer associated with hemorrhage:preliminary results in 16 patients

作　　者：吴伟达[1] 彭建扬[1] 翁志成[1] 周国辉 林元镇 WU Weida;PENG Jianyang;WENG Zhicheng;ZHOU Guohui;LIN Yuanzhen(Department of Intervention,Affiliated Hospital of Putian College,Putian,Fujian Province351100,China)

机构地区：[1]莆田学院附属医院介入科,福建351100

出　　处：《介入放射学杂志》2022年第5期484-488,共5页Journal of Interventional Radiology

摘　　要：目的探讨载药微球经导管动脉化疗栓塞术(DEB-TACE)治疗膀胱癌并出血的可行性。方法回顾2017年12月至2020年12月于收治的16例无法手术或不愿行手术切除的膀胱癌伴出血患者,并均行膀胱动脉超选择栓塞。先于双侧髂内动脉灌注化疗,化疗药物为顺铂(40~60 mg),再超选择至膀胱动脉以载药微球负载表柔比星后栓塞肿瘤血管,采用改良实体瘤疗效评价(mRECIST)标准及血尿复发情况评价疗效,记录其并发症发生情况。结果16例患者共行29次介入治疗,16例患者首次介入术后72 h内完全止血。随访(12.3±5.3)个月,首次介入治疗后2个月CT或MRI影像资料显示,病灶完全缓解(CR)2例,部分缓解(PR)10例,稳定(SD)3例,进展(PD)1例,总有效率(CR+PR)为75.0%,疾病获益率(CR+PR+SD)为93.8%。随访6个月时16例患者均生存。术后均未出现与介入手术相关的严重并发症,轻度不良反应经对症处理后在2~5 d消失。5例患者肿瘤缩小明显,降期后进一步行经尿道膀胱肿瘤电切术治疗。结论载药微球超选择栓塞膀胱动脉可用于治疗膀胱癌伴出血患者,且可明显减少介入手术次数。Objective To investigate the feasibility of drug-eluting beads transcatheter arterial embolization(DEB-TACE)for the treatment of bladder cancer associated with hemorrhage.Methods The clinical data of a total of 16 patients with bladder cancer complicated by hemorrhage,who were unable or unwilling to receive surgery and were admitted to authors’hospital between December 2017 and December 2020 to receive super-selective embolization treatment of the bladder artery,were retrospectively analyzed.After bilateral internal iliac arterial perfusion chemotherapy with 40-60mg cisplatin was performed,super-selective cath eterization of bladder artery was carried out to infuse microspheres loaded with epirubicin,which was followed by embolization of tumor vessels.The curative effect was evaluated based on the modified response evaluation criteria in solid tumor(mRECIST)and the recurrence of hematuria.The events of complications were recorded.Results A total of 29 interventional procedures were performed in 16 patients,with a mean of(1.8±0.8)times per patient.Within 72 hours after initial interventional therapy,complete hemostasis was achieved in all 16 patients,the patients were followed up for a mean of(12.3±5.3)months.CT or MRI performed two months after interventional treatment showed that complete remission(CR)of lesion was observed in 2 patients,partial remission(PR)in 10 patients,stable disease(SD)in 3 patients,and progress disease(PD)in one patient.The total effective rate(CR+PR)was 75.0%and the disease benefit rate(CR+PR+SD)was 93.8%.In a 6-month follow-up period,all 16 patients were alive.No interventional procedure-related serious complications occurred.All mild adverse reactions disappeared after symptomatic treatment for 2-5 days.In 5 patients the tumor volume was significantly reduced,and in whom the transurethral electro-resection of the bladder tumor(TURBT)was carried out after down grading of the tumor was confirmed.Conclusion For the treatment of bladder cancer associated with hemorrhage,super-selective

关 键 词：载药微球 膀胱癌 血尿 超选择膀胱动脉栓塞 

分 类 号：R737.14[医药卫生—肿瘤]