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肌层浸润性膀胱癌保留膀胱术后髂内动脉灌注化疗的临床疗效[J]. 肿瘤防治研究, 2015, 42(08): 810-813. DOI: 10.3971/j.issn.1000-8578.2015.08.013
引用本文: 肌层浸润性膀胱癌保留膀胱术后髂内动脉灌注化疗的临床疗效[J]. 肿瘤防治研究, 2015, 42(08): 810-813. DOI: 10.3971/j.issn.1000-8578.2015.08.013
Clinical Evaluation of Bladder-sparing Surgery Combined with Internal Iliac Artery Chemotherapy for Muscle-invasive Bladder Cancer Patients[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 810-813. DOI: 10.3971/j.issn.1000-8578.2015.08.013
Citation: Clinical Evaluation of Bladder-sparing Surgery Combined with Internal Iliac Artery Chemotherapy for Muscle-invasive Bladder Cancer Patients[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 810-813. DOI: 10.3971/j.issn.1000-8578.2015.08.013

肌层浸润性膀胱癌保留膀胱术后髂内动脉灌注化疗的临床疗效

Clinical Evaluation of Bladder-sparing Surgery Combined with Internal Iliac Artery Chemotherapy for Muscle-invasive Bladder Cancer Patients

  • 摘要: 目的 评价保留膀胱术后联合髂内动脉介入化疗临床疗效。方法 回顾性分析2008年2月— 2013年8月徐州市肿瘤医院经尿道膀胱肿瘤电切术(TURBT)后辅助全身化疗及髂内动脉介入化疗51例膀胱尿路上皮癌患者,分为髂内动脉化疗组(A组19例)和全身化疗组(B组32例),比较两组5年累计生存率、膀胱保留率及不良反应发生率的差异,同时采用多元Logistic回归分析影响髂动脉化疗组患者预后的因素。结果 A、B两组患者5年累积生存率分别为56.5% 和53.2%,差异无统计学意义(P=0.18)。A组膀胱保留率为78.9%(15/19)高于B组62.5%(20/32),差异有统计学意义(P=0.024)。A组患者化疗后并发症发生率低于B组,差异有统计学意义(P=0.036)。相关因素分析显示T2期及单发肿瘤的患者适合于髂内动脉化疗。结论 与GC方案全身化疗相比,保留膀胱术后髂内动脉化疗在保证生存率情况下,具有膀胱保留率高、化疗并发症发生率低等优点,值得临床合理选择运用;影响髂内动脉化疗预后的主要因素有临床分期、病理分级及肿瘤数目。

     

    Abstract: Objective To evaluate the clinical effect of bladder-sparing surgery combined with internal iliac artery chemotherapy on patients with invasive bladder cancer.Methods Fifty-one patients with invasive bladder cancer in Xuzhou Cancer Hospital from Feb., 2008 to Aug., 2013 were randomly divided into two groups. The Group A was treated with transurethral resection of bladder tumor plus internal lilac artery chemotherapy, while the Group B used the TUR-BT and chemotherapy. The bladder preservation rates, 5-year survival rates and the incidence of side effects in these patients were compared. Multivariate Cox regression method was used to analyze the influence factors on patients who received internal iliac artery chemotherapy. Results The 5-year survival rates of Group A and B were 56.5% and 53.2%, respectively(P=0.18); the bladder preservation rates were 78.9%(15/19) and 62.5%(20/32)(P=0.024). Compared with Group B, the complications in Group A was lower(P=0.036). Internal iliac artery chemotherapy was particularly fit for stage T2 and single invasive bladder cancer patients. Conclusion Compared with GCGemcitabine 1 000mg/m2 (d1, 8)+ Cisplatin 30mg/m2(d1-3) chemotherapy, internal iliac artery chemotherapy has the advantages of higher bladder preservation rate and lower complications without influencing survival rate. The main factors affecting the internal iliac artery chemotherapy include clinical TNM stage, histological grade and number of tumors.

     

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