移行细胞癌盆腔复发动脉化疗的疗效观察

Clinical trial of intraarterial chemotherapy for unresectable pelvic recurrence of transitional cell carcinoma

目的评价移行细胞癌盆腔局部复发灶动脉化疗的临床效果.方法2002年12月至2004年1月应用动脉灌注化疗对7例移行细胞癌(膀胱癌5例,输尿管癌2例)术后盆腔局部复发者进行治疗.男4例,女3例.年龄54～68岁,平均60岁.临床分期均为T4,病理分级均为Ⅲ级.化疗方案为健择(吉西他滨)加顺铂.结果完全缓解(CR)4例,部分缓解(PR)3例.随访3～14个月,4例CR患者中,3例无瘤生存5～11个月,1例于治疗后12个月出现全身转移,尚在全身化疗中;3例PR患者中2例肿瘤无进展生存4～6个月,1例于治疗后13个月因肿瘤转移死亡.结论健择加顺铂动脉化疗治疗移行细胞癌盆腔局部复发近期疗效良好.

Objective To evaluate the clinical outcome of intraarterial chemotherapy for patients with unresectable pelvic recurrence of transitional cell carcinoma （TCC）. Methods From December 2002 to January 2004,7 patients （4 men and 3 women; mean age,60 years;age range,54- 68 years） with unresectable pelvic recurrence of TCC （ bladder cancer in 5 patients and distal ureteral cancer in 2 patients） were treated with intraarterial chemotherapy. All of the patients had grade Ⅲ TCC by pathological grading or stage T4 TCC by clinical staging. The regimen consisted of gemcitabine plus DDP. Results Complete response （CR） was obtained in 4 patients,partial response （PR） in 3 patients. The follow-up was 3 -14 months. Three of the 4 patients with CR survived disease-free for 5 to 11 months,the other patient with CR developed systemic metastasis 12 months after intraarterial chemotherapy and is receiving general chemotherapy now. Three patients with PR survived progression-free for 4 to 6 months. One patient with PR died of metastasis 13 months after intraarterial chemotherapy. Conclusions Intraarterial chemotherapy with gemcitabine and DDP is effective in managing patients with unresectable pelvic recurrence of transitional cell carcinoma.