膀胱部分切除加髂内动脉化疗治疗老年人浸润性膀胱癌远期随访

Long term follow up of intra-internal iliac artery infusion chemotherapy and partial cystectomy for invasive bladder cancer in the elderly

目的探讨动脉化疗在老年人浸润性膀胱癌行保留膀胱术后应用的可行性。方法对52例浸润性膀胱癌患者行膀胱部分切除术保留膀胱,同时髂内动脉置化疗泵,术后定期注射化疗药物顺铂（PDD）50 mg及氨甲喋呤（MTX）40 mg,每2周1次,共6次,以后每1个月1次至1年,每3个月1次至3年。结果52例获得6～60个月随访,平均36个月。无复发者36例,有效率69.2%。术后1、2、3、4、5年内分别有4、3、3、2、1例发生局部复发,3例于术后2、3、4年远处转移而死亡。化疗副作用较静脉用药及膀胱腔内灌注明显减轻。结论动脉化疗可以作为老年人浸润性膀胱癌膀胱部分切除术后的辅助治疗,且能保留膀胱功能。

Objective To study the clinical effects of intra-internal lilac arterial chemotherapy for invasive bladder cancer in the elderly after operation. Methods From 2001 to 2006, 52 cases with invasive bladder cancer underwent partial cystectomy, meanwhile arterial infusion pump was implanted in the intra-internal lilac artery, chemotherapy drugs were injected to the pump after operation. The chemotherapy included diamminedichloroplatinum（DDP） 50 mg, methotrexate（MTX） 40 mg, at first, once 2 weeks for 6 times, then once a month to 1 year after operation, afterwards once 3 months to 3 years after operation. Results The patients had been followed up for 6 - 60 months, mean 36 months, 36 of the 52 patients had no recurrence. Partly recurrence was found in 4, 3, 3, 2, 1 cases at 1, 2, 3, 4, 5 years respectively after operation, distant metastasis was found in 3 cases. Lessened side effects were noted in intra-artery chemotherapy than in intra-venous chemotherapy. Conclusions This method might be served as an adjuvant therapy for the invasive bladder cancer of the ederly after partial cystectomy.