保留膀胱综合方法治疗肌层浸润性膀胱癌的疗效评价

Efficacy of combined bladder-preserving therapy for muscle invasive bladder cancer

目的探索保留膀胱手术+膀胱内灌注化疗+动脉灌注化疗治疗浸润性膀胱癌的临床疗效。方法 2003年5月至2012年2月,对经尿道膀胱肿瘤电切或膀胱部分切除后确诊为肌层浸润性膀胱癌(T2N0M0)的56例保留膀胱的患者,给予动脉灌注化疗加膀胱灌注化疗。结果 56例患者均获得随访,随访6～98个月,平均(36.0±3.2)个月,53例(94.6%)患者无复发及转移,3例(5.4%)分别在术后6、8、12复发,复发患者均给于全膀胱切除术,无死亡病例,没有明显并发症。结论保留膀胱手术后确诊的肌层浸润性膀胱癌患者,采用经髂内动脉灌注化疗+膀胱内灌注化疗的联合治疗方法,能有效减少肿瘤复发,显著降低静脉化疗的副作用,提高患者的生活质量,患者易于接受,值得进一步探讨。

Objective To evaluate the efficacy of bladder-preserving therapy combined with infusion chemotherapy and intra-arterial chemotherapy for muscle invasive bladder cancer.Methods 56 cases were diagnosed as muscle invasive bladder cancer（T2N0M0） after being treated with transurethral resection of bladder tumor（TURBT） or partial resection of the bladder.The patients then received iliac artery chemotherapy plus bladder infusion chemotherapy.Results During the follow-up of 6～98 months（mean 36±3.2）,53 cases developed no recurrence or metastasis,and no serious complications were detected.3 cases recurred in the 6th,8th and 12th month respectively after bladder-sparing surgery,which then underwent radical cystectomy.Conclusions For patients with muscle invasive bladder cancer,bladder-preserving operation combined with intra-arterial chemotherapy and bladder infusion chemotherapy can reduce tumor recurrence and side-effects of intravenous chemotherapy,and improve patients＇ quality of life.