Combined modality therapy following bladder conservation surgery for bladder cancers  

膀胱癌保存膀胱术后综合治疗预防复发的疗效

作　　者：孙晓南[1] 胡建斌[1] 杨起初[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院放射治疗科,杭州,310016

出　　处：《Chinese Medical Journal》2002年第10期1548-1551,共4页中华医学杂志（英文版）

摘　　要：OBJECTIVE: To analyze the efficacy of recurrence prophylaxis using radiation and chemotherapy following bladder conservation surgery for muscle invasive bladder cancer. METHODS: 23 patients with muscle invasive bladder cancer were treated with radiotherapy combined with bladder mitomycin infusion after bladder conservation surgery (study group). Radiotherapy was given using an external beam at an average dose of 5148 +/- 462 cGy with conventional fractionation. For comparison, 29 similar patients treated with postoperative bladder mitomycin infusion without radiation served as control (control group). All patients were followed up for more than 3 years, an average of 41.6 months (36 - 60 months). RESULTS: The 3-year pelvic recurrent rate of muscle invasive bladder cancer was 17.4% in the study group and 44.8% (P = 0.036) in the control group. The 3-year distant metastasis rates were 17.4% and 24.1%, respectively (P = 0.554). The 3-year overall survival rates were 81.8% and 86.2%, respectively (P = 0.670). Two patients from the study group had their treatment interrupted, one for 3 days and the other for one week due to acute cystitis, while the rest of the patients were able to complete the treatment according to schedule. CONCLUSION: Radiotherapy plus chemotherapy after bladder conservation surgery for muscle invasive bladder cancer can decrease the rate of pelvic recurrence effectively and be used as a realistic adjuvant treatment.目的探讨放射治疗+化疗预防肌层侵犯的浸润性膀胱癌保存膀胱术后复发的疗效.方法 23例肌层侵犯的浸润性膀胱移性细胞癌保存膀胱术后在丝裂霉素规则膀胱灌注化疗的基础上行放射治疗(研究组),照射平均剂量为5148±462 cGy.以29例同期同样病变行保存膀胱术后单纯丝裂霉素规则膀胱灌注化疗的为对照(对照组).所有病例随访3年以上,平均随访41.6个月(36-60).结果研究组和对照组3年盆腔复发率为17.4%和44.8%(P=0.036);3年远地转移率分别为17 .4和24.1%(P=0.554);3年生存率分别为81.8%和86.2%(P=0.670).研究组除2例因放射性膀胱炎分别中断3d和1周后继续治疗外,其余均按计划完成治疗.结论保存膀胱术后放射+化疗治疗能有效降低肌层肌层侵犯浸润性膀胱癌盆腔复发率,且是膀胱癌保膀胱术后理想的辅助治疗.

关 键 词：ADULT Aged Bladder Neoplasms Combined Modality Therapy FEMALE Humans MALE Middle Aged Neoplasm Recurrence  Local Survival Rate 

分 类 号：R737.14[医药卫生—肿瘤]