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目的评价经导管双侧髂内动脉灌注化疗治疗膀胱癌的疗效及安全性。方法 2008年6月至2009年12月,对23例浸润性膀胱癌患者行50例次经导管双侧髂内动脉灌注化疗,化疗药物为吉西他滨和顺铂。结果全部患者双侧髂内动脉插管均成功,术后不良反应包括发热4例次(8%),恶心、呕吐15例次(30%),厌食5例次(10%),穿刺点血肿4例次(8%),白细胞降低(<3×109/L)1例次(2%)。经导管灌注化疗后,完全缓解(CR)2例(8.7%),部分缓解(PR)20例(87.0%),病情稳定(SD)1例(4.3%)。PR患者瘤体明显缩小,接受经尿道膀胱肿瘤电切术。全部病例随访3～12个月,平均5个月。肿瘤复发3例(13.0%),再次行经尿道膀胱肿瘤电切术。结论经导管双侧髂内动脉灌注化疗治疗浸润性膀胱癌有效、安全。
Objective To evaluate the efficacy and safety of transcatheter arterial infusion chemotherapy for bladder cancer. Methods From June 2008 to December 2009, 50 patients underwent bilateral internal iliac artery infusion chemotherapy in 23 patients with invasive bladder cancer. Chemotherapy drugs were gemcitabine and cisplatin. Results All patients received bilateral internal iliac artery cannulation successfully. Postoperative adverse reactions included 4 cases (8%) of fever, 15 cases of nausea and vomiting (30%), 5 cases of anorexia (10%), puncture point hematoma 4 cases (8%), leukopenia (<3 × 109 / L) in 1 case (2%). Two patients (8.7%) had complete remission (CR), 20 (87.0%) had partial remission (PR), and 1 patient (4.3%) had stable disease (SD) after catheterized chemotherapy. PR patients significantly reduced tumor, transurethral resection of the bladder tumor. All cases were followed up for 3 to 12 months, an average of 5 months. Tumor recurrence in 3 cases (13.0%), once again underwent transurethral resection of the bladder tumor. Conclusion Intraductal bilateral internal iliac artery infusion chemotherapy in the treatment of invasive bladder cancer is effective and safe.