髂内动脉化疗辅助经尿道电切治疗浸润性膀胱癌的临床研究

目的评价动脉介入化疗辅助经尿道电切治疗浸润性膀胱癌的效果。方法对13例病理证实为肌层浸润性的膀胱移行细胞癌（T2-T3）的患者行经尿道电切术＋辅助动脉介入化疗。经骼内动脉灌注的化疗药物为顺铂80mg、表柔比星50mg,氟尿嘧啶1g或喜树碱30mg。经辅助动脉介入化疗后,所有病例定期随访,观察其生存期、无病生存期以及化疗副作用等。结果13例患者完成治疗,年龄68.3±7.4岁,平均随访26.46个月,肿瘤复发5例（38.46%）,对复发肿瘤行再次经尿道切除,1例远处转移行全身化疗。2例患者因癌死亡。结论选择辅助介入化疗结合经尿道切除的治疗对部分肌层浸润性的膀胱移行细胞癌（T2-T3）的患者具有一定的疗效,并具有保留膀胱功能、较好生活质量的优点。

Combinations of adjuvant chemotherapy after local resection for bladder cancer with muscle invasion

Objective To evaluate the efficacy of bladder preservation treatment by adjuvant intra-arterial chemotherapy after transurethral resection for patients with bladder cancer with muscle invasion.Methods Thirteen patients who had muscle invasive transitional cell carcinoma of bladder （T2-T3）were treated with adjuvant intra-arterial chemotherapy after transurethral resection.The chemotherapy regimen consisted of cisplatin 80mg,epirubicin 50mg,fluorouracil 1g,or camptothecin 30mg.After intra-arterial chemotherapy,all patients had regular follow-up and their life span life,disease free survival,disease free survival were observed.Results Thirteen patients （mean age,68.3±7.4 years） completed the treatment and showed good tolerance.With a median follow-up of 26.46 months,local recurrence or distant metastasis occurred in 5 patients （38.46%）.Recurrent tumors were treated with transurethral resection or systematic chemotherapy.Two patients died of bladder cancer.Conclusion Adjuvant intra-arterial chemotherapy and bladder preservation operation is a feasible and promising treatment for patients with bladder cancer with muscle invasion （T2-T3）,which can remain patients＇ bladder function and give better quality of life.