原发小细胞膀胱癌5例报告和文献复习

Literature Review of Primary Small－Cell Bladder Cancer (A Report of 5 Cases)

目的：报告５例小细胞膀胱癌治疗结果，复习相关文献，探讨小细胞膀胱癌临床特点，手术、化疗和放疗在小细胞膀胱癌治疗中的作用。方法：我院从１９７９～１９９９年收治５例小细胞膀胱癌患者，其中Ｔ１Ｎ０Ｍ０１例，接受双髂内动脉导管化疗；Ｔ２Ｎ０Ｍ０１例，行膀胱切除术加术后放疗；Ｔ３Ｎ０Ｍ０１例，仅行膀胱切除术；Ｔ４Ｎ０Ｍ０２例，１例经放疗、动脉导管化疗后行探查术，另１例术前放疗后膀胱切除术加术后全身化疗。

Objective To evaluate the curative effect of five cases of primary small－cell bladder cancer． To discuss the clinical features of primary small－cell bladder cancer and the role of operation chemotherapy and radiotherapy in treating the disease by related literature reviews． Methods From 1979 to 1999 five patients with primary small－cell bladder cancer were treated． One case of stage T1N0M0 was treated by bilateral internal iliac artery transcatheteral chemotherapeutic injection TAI． One patient of stage T2N0M0 underwent cystectomy plus postoperative radiotherapy． One case of stage T3N0M0 had cystectomy． One case of stage T4N0M0 underwent cystectomy after preoperative radiotherapy and TAI another case of stage T4N0M0 had cystectomy combined with chemotherapy after preoperative radiotherapy． Results Two cases of stage T1 and T2 cancer survived well until now． One case of T3 died of local recurrence and distal metastasis two years after diagnosis． Two cases of T4 survived for 6 months and 4 years． Conclusion The survival rate of the patient is associated with the stage of the tumor and the best treatment of this disease is systemic chemotherapy take DDP as the dominant agent combined with radical surgery and／or radiotherapy．