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目的:评价保留膀胱手术后联合髂内动脉介入化疗治疗浸润性膀胱癌的临床疗效。方法:2003年6月～2009年2月对46例浸润性膀胱移行细胞癌患者采用经尿道膀胱肿瘤电切或膀胱部分切除术联合顺铂+吡喃阿霉素方案髂内动脉化疗进行治疗。结果:46例患者均获得随访,平均随访38(9～68)个月。33例无瘤生存,2例带瘤生存,11例死于肿瘤转移,5年生存率为75.76%;29例保留膀胱生存,10例行挽救性全膀胱切除,其中全膀胱切除术后死亡4例,5年膀胱保存率为73.32%;其中33例T_2期患者5年生存率为83.21%;5年膀胱保留率为81.82%。全部患者对动脉化疗耐受良好,无严重全身和局部不良反应。结论:保留有功能的膀胱手术加髂内动脉灌注化疗为治疗浸润性膀胱移行细胞癌的有效方法之一,尤其是早期浸润性膀胱癌(T_2期)患者,是保留膀胱治疗的最佳适应证。
Objective: To evaluate the clinical efficacy of bladder cancer after bladder surgery combined with interventional chemotherapy of internal iliac artery in the treatment of invasive bladder cancer. Methods: From June 2003 to February 2009, 46 patients with invasive bladder transitional cell carcinoma were treated with transurethral resection of bladder tumor or partial cystectomy combined with cisplatin plus pirarubicin for internal iliac artery chemotherapy. Results: All 46 patients were followed up for an average of 38 (9 ~ 68) months. 33 cases survived without tumor, 2 cases survived tumor, 11 died of tumor metastasis, and the 5-year survival rate was 75.76%. 29 cases survived bladder and 10 cases achieved salvage total cystectomy, of which 4 died after cystectomy The 5-year bladder preservation rate was 73.32%. The 5-year survival rate of 33 T 2 patients was 83.21%. The 5-year bladder retention rate was 81.82%. All patients were well tolerated by arterial chemotherapy without serious systemic and local adverse reactions. CONCLUSION: One of the effective methods of preserving functional bladder surgery plus internal iliac arterial infusion chemotherapy is to treat invasive bladder transitional cell carcinoma, especially in patients with early invasive bladder cancer (T 2 stage), which is the best indication for bladder treatment .