高能聚焦超声联合吡柔比星姑息性治疗膀胱癌(附18例报告)

Application of high-intensity focused ultrasound combined pirarubicin in the palliative treatment for bladder cancer(Report of 18 cases)

目的：探讨高能聚焦超声（HIFU）联合吡柔比星（THP）膀胱灌注姑息性治疗膀胱癌的临床疗效。方法：选取18例不能或不愿承受手术治疗的T2a期及以上分期的膀胱肿瘤患者,予以HIFU联合THP姑息性治疗。患者每周行HIFU治疗2次,每次治疗时间20-40min,总疗程为2-3周。在HIFU治疗的同时给予THP30mg膀胱灌注,每周1次,连续灌注8周后改为每月1次,维持6-12个月,并观察其疗效。结果：7例（38.9%）膀胱三角区肿瘤治疗前后大小分别为（4.84±1.21）cm和（2.61±1.02）cm,6例（33.3%）膀胱侧壁肿瘤治疗前后大小分别为（4.62±1.42）cm和（2.22±1.10）cm,5例（27.8%）膀胱底部肿瘤治疗前后大小分别为（4.21±1.11）cm和（2.32±1.22）cm,各部位肿瘤直径经治疗后均有明显减小,差异有统计学意义（P〈0.01）。治疗后大部分患者生活质量明显改善,血尿、尿频、尿急、尿痛等膀胱刺激症状明显减轻,无严重并发症。结论：HIFU联合THP膀胱灌注治疗可以明显减小膀胱肿瘤体积,是治疗膀胱癌的有效方法。

Objective：To evaluate the applicaion of high-intensity focused ultrasound（HIFU）combined pirarubicin（THP）in the palliative treatment for bladder cancer.Method：We chose 18 bladder cancer patients with T2 a or worse stage who were not suitable for operation or didn＇t want to receive operation.All patients were treated with HIFU combined pirarubicin,and their curative effects were observed.HIFU were performed twice per week for 2-3weeks,the duration was 20-40 minutes every time.At meantime,pirarubicin was used once per week for eight weeks,then once per month for 6-12 months.Result：After treatment,the size of seven（38.9%）bladder cancers in trigone decreased from（4.84±1.21）cm to（2.61±1.02）cm,six（33.3%）in side walls decreased from（4.62±1.42）cm to（2.22±1.10）cm,and five（27.8%）in fundus decreased from（4.21±1.11）cm to（2.32±1.22）cm.The size of bladder cancer among three groups decreased significantly（P〈 0.01）.The life quality of the most of patients improved significantly,and patients＇ bladder irriative symptoms of hematuria,frequence,urgency and dysuria relieved dramatically.Moreover,no severe complications occurred during the treatment.Conclusion：HIFU combined pirarubicin is an effective treatment for bladder cancer,for it can obviously decrease the size of bladder cancer.