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目的比较术前放疗加全膀胱切除术和单纯全膀胱切除术在膀胱癌患者Ｔ３期治疗中的疗效。方法２６例 Ｔ３期移行细胞膀胱癌患者为术前放疗组，术前放疗剂量为 ＤＴ ２０ Ｇｙ／５次，共 ５日，放疗后一周内手术。中位随访时间为４８个月（２１～８４个月）。３６例Ｔ３期患者行单纯全膀胱切除术（单手术组），中位随访时间４４个月（１３～８４个月）。全部病例随访率１００％。结果术前放疗组３年盆腔复发率０％低于单手术组１９．４％（Ｐ＜０．０５），５年盆腔复发率１１．５％及腹壁切口复发率０％低于单手术组的２５．０％和１１．１％，５年生存率术前放疗组５７．６％，单手术组４４．４％。结论Ｔ３期膀胱癌患者接受术前放疗可以降低盆腔复发率。
Objective To compare the efficacy of preoperative radiotherapy plus total cystectomy and simple cystectomy in the treatment of bladder cancer patients with T3. Methods Twenty-six patients with T3 transitional cell bladder cancer were treated with preoperative radiotherapy. The dose of radiotherapy was DT 20 Gy / 5 times for 5 days and one week after radiotherapy. The median follow-up time was 48 months (21-84 months). 36 cases of T3 patients underwent simple total cystectomy (single operation group) with a median follow-up time of 44 months (range, 13-84 months). All cases follow-up rate of 100%. Results The 3-year pelvic recurrence rate of preoperative radiotherapy group was lower than that of the single operation group (19.4%, P <0.05), the 5-year pelvic recurrence rate was 11.5% and the rate of abdominal incision recurrence was 0% 25.0% and 11.1% respectively. The 5-year survival rate was 57.6% in the preoperative radiotherapy group and 44.4% in the single operation group. Conclusion Patients with stage T3 bladder cancer receiving preoperative radiotherapy can reduce the recurrence rate of pelvic cavity.