经导管动脉灌注化疗治疗膀胱癌的研究

A study on transcatheter intra arterial chemotherapy for bladder cancer

目的总结大剂量顺铂＋阿霉素方案经导管髂内动脉灌注治疗膀胱癌的近期疗效。方法对７６例经病理证实且肾功能正常的膀胱癌患者行大剂量顺铂＋阿霉素髂内动脉灌注化疗。对比观察治疗前后肿瘤组织病理及超微结构的变化。结果７６例患者中，完全缓解（ＣＲ）１１例（１４．４７％），部分缓解（ＰＲ）４５例（５９．２１％），无效者２０例（２６．３２％），总反应率７３．６８％。有病理学资料的４２例患者中，化疗后，８例（１９．０５％）移行细胞癌肿瘤分级有所降低，６例（１４．２９％）病理学检查肿瘤细胞消失。肿瘤细胞超微结构的改变明显。结论大剂量顺铂＋阿霉素方案对于膀胱癌疗效明显，值得推广。

Objective To evaluate the short term effects of transcatheter intra arterial chemotherapy with high dose CDDP and ADM on bladder cancer. Materials and Methods 76 patients with pathologically confirmed bladder cancer were treated with high dose CDDP and ADM by transcatheter intra arterial perfusion chemotherapy. The doses were CDDP:100mg/m 2,ADM:30mg/m 2. With 2 cycles by an interval of 3～4 weeks, pathological changes before and after the therapy under optical microscope and electron microscope were compared. The short term effects and side effects of this method were analyzed. Results Complete response in 11(14.47%) and a partial response in 45(59.21%) of the patients were achieved after the therapy. 20(26.32%) had no response. The total anticancer effective rate was 73.68%. Pathological findings of 42 patients indicated downstaging in 8(19.05%) patients, no tumor cell found in 6(14.29%) patients. Distinct supermicro structural changes were observed under electron microscope. Side effects were tolerable. Conclusion Intra arterial chemotherapy for bladder cancer with high dose of CDDP and ADM is effective, but the patients with a decreased renal function should not be recommended.