两种保留膀胱治疗方法对肌层浸润性膀胱癌的疗效比较

Comparison between two methods of bladder reservation for muscle-invasive bladder cancer

目的比较经尿道膀胱肿瘤切除术(TURBT)后联合静脉化疗与术后联合髂内动脉灌注化疗对T_2N_0M_0期膀胱癌的疗效。方法T_2期肌层浸润性膀胱癌患者54例,其中行TURBT联合静脉化疗(静脉化疗组)28例,行TURBT联合髂内动脉灌注化疗(动脉化疗组)26例。比较两组患者的一般资料、围手术期情况、术后不良反应发生情况等,统计两组患者总体生存率、无复发1年生存率、无复发2年生存率。结果两组患者一般资料及围手术期情况比较均无明显差异,动脉化疗组治疗后血常规异常及肝肾功能损害情况明显低于静脉化疗组,且前者无复发1年生存率明显高于后者。结论对于T_2N_0M_0期膀胱癌患者,TURBT后联合髂内动脉灌注化疗相较于术后联合静脉化疗,其无复发1年生存率明显增高,且血常规异常及肝肾功能损害等情况显著下降。

Objective To compare the curative effect between intravenous chemotherapy and postoperative internal iliac artery infusion chemotherapy after transurethral resection of bladder tumor（TURBT）on T2N0M0 stage bladder cancer. Methods Fifty-four patients with stage T2 muscle-invasive bladder cancer were treated with TURBT combined with intravenous chemotherapy（intravenous chemotherapy group）in 28 cases and internal iliac artery infusion chemotherapy（arterial chemotherapy group）in 26 cases.The general condition of the two groups,the perioperative situation and the incidence of postoperative adverse reactions were compared,and the total survival rate,the 1-year survival rate without recurrence and the 2-year survival rate without recurrence were compared between the two groups. Results There was no significant difference in the general data and perioperative conditions between the two groups.The abnormal blood and liver and kidney function in the arterial chemotherapy group were significantly lower than those in the intravenous chemotherapy group,and 1-year recurrence-free survival rate in the former group was significantly higher than that of the latter. Conclusions For T2N0M0 bladder cancer patients,TURBT combined with internal iliac artery infusion chemotherapy showed higher 1-year recurrence-free survival rate and less change in blood routine and liver and renal function compared with postoperative intravenous chemotherapy.