膀胱局限性浸润癌保留膀胱综合性治疗

Comprehensive treatment on bladder preservation in limitation invasive bladder cancer

目的探讨膀胱局限性浸润癌保留膀胱综合性治疗的疗效。方法对9例膀胱局限性浸润癌患者以保留膀胱的综合性治疗,9例术前2～3周行以顺铂为基础的多种药物选择性髂内动脉灌注化疗。化疗后肿瘤分期为T2～T3a患者行经尿道肿瘤电切术,化疗后肿瘤分期为T3b～T4患者行膀胱部分切除术。术后经过病理活检了解肿瘤切除情况,如有肿瘤残留则于术后2～4周行放射治疗。门诊定期随访2～3年,定期膀胱灌注化疗,定期复查膀胱镜。结果所有患者保留膀胱,8例复查6～18月未发现肿瘤复发,1例出现肿瘤复发,总有效率为88.8%(8/9)。结论膀胱局限性浸润癌保留膀胱综合性治疗是不能耐受根治性全膀胱切除术及拒绝切除膀胱患者的最佳选择。

Objective To investigate the efficacy of comprehensive treatment on bladder preservation in limitation invasive bladder cancer. Methods Nine cases of patients with limitation invasive bladder cancer were given comprehensive treat ment of bladder preservation, the 9 patients were given various drugs based on Cisplatin with selective internal iliac arteri al infusion chemotherapy in preoperative 2-3 weeks. After chemotherapy, patients with the tumor staging for T2-T3a were given transurethral resection of bladder tumor, patients with tumor staging for T3b-T4 were given partial cystectomy. Pathological biopsy were made to know the situation of tumor resection after operation, radiation therapy was used after op- eration of 2-4 weeks if residual tumors were found. Outpatients were followedup in 2-3 years, and were given regular bladder perfusion chemotherapy, and regularly reviewed the cystoscope. Results All cases retained the bladder, 8 cases with no recurrence occurred in the review of 6 to 18 mouths, 1 case was found with tumor recurrence, the total effective rate was 88.8% （8/9）. Conclusion Comprehensive treatment on bladder preservation in limitation invasive bladder cancer is the best choice when the patients who is not tolerated radical cystectomy and refused resection of bladder.