动脉插管化疗配合术中黏膜注射IL-2、术后膀胱灌注治疗非肌层浸润、多发、复发性膀胱癌

Application of Arterial Incubation Chemotherapy,Submucosal Injection of IL-2 and Perfusion of Bladder to Cure Non-muscle Invasive,Recurrent,and Multiple Bladder Cancer

目的探讨腹壁下动脉插管化疗配合术中黏膜注射IL-2、术后膀胱灌注吡柔比星治疗非肌层浸润、多发、复发性膀胱癌的疗效。方法对23例非肌层浸润、多发、复发性膀胱尿路上皮癌患者术中黏膜注射IL-2,术后进行腹壁下动脉插管化疗3个疗程后,开始行吡柔比星膀胱灌注,每次30 mg,每周1次共12次,以后每2周1次(共6次),以后每月1次(共6次);第2年重复;第3年,每月1次。术后每3个月复查膀胱镜,定期随访。结果23例非肌层浸润、多发、复发性膀胱癌患者,术后随访24～48个月,肿瘤复发3例,复发率为13%。术后不良反应为尿路刺激症状和膀胱容量小。结论腹壁下动脉插管化疗配合术中黏膜注射IL-2、术后膀胱灌注吡柔比星治疗非肌层浸润、多发、复发性膀胱癌的临床效果明确,疗效满意。

Objective To investigate the therapeutic effect of arteria epigastria inferior incubation chemotherapy, submucosal injection of IL-2 and perfusion of bladder to cure non-muscle invasive,recurrent,and multiple bladder cancer.Methods A total of 23 patients,who were suffered from non-muscle invasive,recurrent,and multiple bladder cancer,were selected.These patients were given submucosal injection of IL-2 in the operation, applied arterial incubation chemotherapy for 3 courses after operation,and then,began to perfuse pirarubicin at a dose of 30mg every one week for 12 times,then,every two weeks for 6 times,lastly,every month for 6 times.The courses were repeated in the second year.In the 3rd year,perfusion of the drug was applied every month.The cystoscopy was done every 3 months,and regular follow-up was done after operation.Results All the 23 patients were followed up for 24～48 months after operation,only 3 patients recurred（recurrence rate were 13%）.The main adverse effects were urethral irritation and lower capacity of bladder.Conclusion The therapeutic effect of arterial epigastria inferior incubation chemotherapy,submucosal injection of IL-2 and perfusion of bladder to non -muscle invasive,recurrent,and multiple bladder cancer might be better and satisfactory.