浸润性膀胱癌术后放疗加顺铂膀胱灌注预防复发的疗效观察

目的　探讨浸润性膀胱癌保留膀胱术后放疗联合顺铂膀胱灌注预防复发的疗效。方法　全组共 46例 ,随机分为治疗组与对照组。治疗组 2 4例 ,采用术后放疗加顺铂膀胱灌注。对照组 2 2例 ,于膀胱部分切除术后行顺铂膀胱灌注。并观察分析 2组的复发率、全膀胱切除率及不良反应。结果　治疗组局部复发 4例 ,复发率 16.7% ,其中 1例 (4 .2 % )行全膀胱切除 ;对照组局部复发 9例 ,复发率 40 .9% ,其中 4例 (18.2 % )行全膀胱切除。治疗组复发率及全膀胱切除率较对照组均降低 ,有显著性差异 (P <0 .0 5 )。结论　浸润性膀胱癌保留膀胱术后行放疗加顺铂膀胱灌注能有效降低复发率 ,并能降低全膀胱切除率 ,从而提高患者的生存质量

Postoperative Radiotherapy Combined with Cisplatin Intravesical Infusion to Prevent Relapse in Invasive Bladder Cancer

Objective To evaluate the effect of intravesical infusion plus radiotherapy following bladder-preserving surgery in invasive bladder cancer.Methods Forty-six patients with bladder cancer were randomized into treatment group and control group.24 cases in the treatment group were treated with bladder-preserving surgery which was followed by external radiation combined with cisplatin intravesical infusion.22 patients who received cisplatin intravesical infusion alone after partial cyctectomy served as control(control group).The recurrence rate,total cyctectomy rate and side effect were observed.Results The local recurrence(4 patients)rate in treatment group was 16.7% and 1 patient(4.2%) received total cyctectomy.The local recurrence(9 patients) rate in control group was 40.9% and 4 patients(18.2%) received total cytectomy.Compared with the control group,the local recurrence rate and total cyctectomy rate were lower,with a statistically significant difference(P<0.05).Conclusion It is demonstrated that the effect of adjuvant radiation and cisplatin intravesical infusion following bladder-preserving surgical procedure are encouraging by decreasing recurrence rate and total cyctectomy rate.