髂内动脉化疗联合手术治疗膀胱癌

A study of internal iliac artery chemotherapy combined with operation for urinary bladder carcinoma

目的:提高膀胱癌手术治疗的效果,尽可能保留有功能的膀胱,降低膀胱癌术后复发率。方法:对72例不同分期、分级的膀胱移行细胞癌患者随机分为两组,Ⅰ组40例行膀胱部分切除术或经尿道膀胱肿瘤电切术(TUR-Bt),术后加丝裂霉素膀胱灌注化疗;Ⅱ组32例术前行卡铂配伍阿霉素髂内动脉灌注化疗2次,后行膀胱部分切除术或经尿道膀胱肿瘤电切术,术后加丝裂霉素膀胱灌注化疗。均随诊2年,比较两组间治疗后膀胱癌复发率。结果:Ⅰ组,2年膀胱癌复发18例,复发率45%。Ⅱ组,2年膀胱癌复发6例,复发率18.75%。两组复发率比较差异有显著性(P<0.05)。Ⅱ组髂内动脉灌注化疗前后膀胱癌细胞分级(G)降低15例,分期(T)降低16例。结论:术前加用卡铂配伍阿霉素髂内动脉灌注化疗可使部分膀胱癌降级、降期,提高手术切除率,降低术后膀胱癌复发率,术前加用卡铂配伍阿霉素髂内动脉灌注化疗结合保留膀胱的手术是治疗膀胱癌的有效方法。

Objective： To elevate the surgery effect of bladder cancer and try to remain the bladder function as well as reduce recurrence. Methods： Seventy-two patients were divided into two groups randomly. The contrast group （40 cases） received partial cystectomy or TUR Bt and postoperately bladder infusion chemotherapy. The study group （32 cases） received twice intra-artery infusion chemotherapy preoperately and partial eystectomy or TUR Bt, and bladder infusion chemotherapy postoperately. Both the groups were followed up for two years, and the recurrence rates were compared. Results： Eighteen and 6 eases recurred in the contrast group （45%） and the study group （18.75%） respectively after two years followed up. There was a significant difference between the two groups. Conclusion： Intra-artery infusion chemotherapy preoperately can decrease the degree and grade of bladder cancer and increase the surgery chance as well as reduce recurrence. The method of intra-artery infusion chemotherapy preoperatety and bladder reserve operation is effective and useful for bladder cancer.