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目的 :评价新辅助动脉介入化疗、盆腔放疗结合经尿道切除治疗浸润性膀胱癌的效果。方法 :对 13例平均年龄 6 8.3岁、有膀胱全切指征而患者无法耐受或不愿接受膀胱全切手术的浸润性膀胱移行细胞癌 (T2～ 3 /G1～ 3 )进行保留膀胱的治疗。治疗方式采用新辅助动脉介入化疗、盆腔放疗及经尿道切除。经髂内动脉灌注的化疗药物为顺铂 80mg、表柔比星 5 0mg、氟尿嘧啶 1g或喜树碱 30mg ,放疗平均剂量为 30～ 5 0Gy。 结果 :经新辅助动脉介入化疗及盆腔放疗 ,膀胱癌瘤体明显缩小 ,完全缓解 (CR) 1例 (7.6 9% ) ,部分缓解 (PR) 12例 (92 .31% ) ,缩小的癌灶经尿道电切或钬激光得以顺利切除 ,患者膀胱得以保留。所有病例定期随访 ,平均随访 2 6 .4 6个月。肿瘤复发 5例 (38.4 6 % ) ,对复发肿瘤行再次经尿道切除或化、放疗。结论 :虽然根治性膀胱全切术是浸润性膀胱癌的主要治疗方法 ,但在部分病例中可选择新辅助介入化疗、放疗结合经尿道切除的治疗 ,初步的结果提示疗效良好 ,且患者保留膀胱功能、获得了较好的生活质量。
Objective: To evaluate the effect of neoadjuvant artery interventional chemotherapy and pelvic radiotherapy combined with transurethral resection for the treatment of invasive bladder cancer. Methods: Thirteen patients with invasive bladder transitional cell carcinoma (T2 ~ 3 / G1 ~ 3) with a mean age of 6 8.3 years and with indications of complete bladder resection but who were unable to tolerate or did not want to undergo total bladder resection treatment. Treatment of neoadjuvant arterial interventional chemotherapy, pelvic radiotherapy and transurethral resection. Intra-iliac artery chemotherapy drugs for cisplatin 80mg, epirubicin 50mg, fluorouracil 1g or camptothecin 30mg, the average dose of radiotherapy 30 ~ 50Gy. Results: The tumor volume of bladder cancer was significantly reduced by neoadjuvant interventional chemotherapy and pelvic radiotherapy. One patient (7.69%) had complete remission (CR), 12 (92.31%) had partial remission (PR) Transurethral resection or holmium laser to be successfully removed, the patient’s bladder can be retained. All patients were followed up regularly for an average of 26.46 months. Tumor recurrence in 5 cases (38.4%), the recurrence of tumor line transurethral resection or chemotherapy, radiotherapy. Conclusions: Although radical cystectomy is the main treatment for invasive bladder cancer, neoadjuvant chemotherapy and radiotherapy combined with transurethral resection may be used in some cases. The preliminary results suggest good efficacy and the patients retain the bladder Function, get a better quality of life.