阴茎癌综合治疗的探讨

Investigation of combined treatment for penis neoplasms

目的探讨不同病期阴茎癌患者予术前辅助化疗、手术、术后化疗、放疗等综合治疗的选择与效果。方法2003年-2008年对37例不同病期阴茎癌患者部分术前辅助化疗2个疗程,术后化疗4-6个疗程,主要为博莱霉素顺铂、氨甲碟呤单用或联合用药,单药主要以博莱霉素为主。予术前辅助化疗、手术、术后化疗、放疗等综合治疗。结果本组37例病人中,直接一期手术者10例(27.0%),术前辅助化疗者27例(73.0%)。化疗的27例病人术后病理证实有化疗反应19例(70.3%),无化疗反应8例(29.6%)。27例病人有5例病情进展,于化疗1-2个周期间停止改手术加放疗。单纯手术者有3例多发或伴有淋巴结转移而再次手术加化疗及放疗。经随访均取得满意疗效。结论术前辅助化疗可予患者控制病情,缩小病灶,提高治疗效果。术后病理有化疗反应预示患者预后良好。

Objective To evaluate the treatment of preoperative adjuvant chemotherapy of peins cancer combined with operation, postoperative chemotherapy and radiotherapy. Methods Thirty-seven cases of penis cancer were analyzed retrospectively. All eases received operation, postoperative chemotherapy and radiotherapy. Most of them received two courses of preoperative adjuvant chemotherapy with DDP, MTX and Neomycin. Results of the 37 patients, 10 patients （27.0%） received one-stage operation, and 27 patients （73.0%） received preoperative adjuvant chemotherapy. In chemotherapy patients, 19 patients （70.3%） showed chemotherapy respense, proved by postoperative pathological examination, and 8 patients （29.6%） showed no chemotherapy response. In 27 chemotherapy patients, 5 experienced disease progressions, chemotherapy was aborted in phase 1- 2 of treatment cycle, and received operation with radiotherapy. In 10 operation patients, 3 accompanied by swollen lymph nodes received the second operation with chemotherapy and radiotherapy. Curative effect is certificated satisfactory by follow-up investigation. Conclusion Preoperative adjuvant chemotherapy can decrease the stage of penis cancer and is beneficial to prognosis.