【摘要】 目的探索手术+膀胱内灌注+介入化疗治疗浸润性膀胱癌的疗效。方法对10例确诊为浸润性膀胱癌(T2-4/G1-3)的病人采用TURBt或膀胱部分切除术+经髂内动脉介入化疗+膀胱内灌注治疗。手术结束后当天,开始用丝裂霉素20mg或羟基喜树碱10mg行膀胱灌注。手术标本经病理确诊后,经股动脉插管达髂内动脉,给予丝裂霉素10mg,长春花碱30mg,顺铂90mg后拔管。结果3例治疗一次,2例治疗两次(间隔一个月),随访2~5年,未见肿瘤复发。2例术后2、7月时复发,再次予以重复治疗并在随访中。1例晚期膀胱癌,伴肺、脑转移,经联合应用放射粒子植入、γ刀放疗等,存活5年。1例盆腔广泛转移的患者,治疗两次后拒绝治疗,半年后死于癌肿。1例治疗时间较短,在随访中。结论初步结果表明,对于确诊的局限性浸润性膀胱癌的患者,在手术后,采用经髂内动脉插管介入化疗+膀胱内灌注化疗的联合治疗方法,能明显的提高疗效,有效地减少肿瘤的复发,显著的降低了静脉化疗的副作用,提高了患者的生活质量,患者易于接受,值得进一步探讨。更多还原

【Abstract】 Objective To explore the efficacy of combinations of opertion and infusion chemotherapy and intra-arterial chemotherapy for bladder cancer with muscle invasion. Methods 10 cases diagnosed as invasive bladder cancer (T2-4/G1-3) patients using TURBt or partial resection of the bladder + the iliac artery chemotherapy + bladder infusion chemotherapy. All patients had muscle invasive carcinoma of bladder (T2-4/G1-3).After the surgery the same day, starting with MMC 20 mg or 10 mg HCPT to the bladder catheter infusion. Surgery confirmed by pathology specimens, the femoral artery catheterization of iliac artery, as far as possible super-select plug into the supply of vascular tumor site, to MMC 10 mg, vinorelbine 30 mg, cisplatin 90 mg after extubation. Results three cases of a follow-up 2 to 5 years, no tumor recurrence. Two cases of two (one month interval), of which one case of follow-up two years, died of cerebral vascular acci-dent, one case of another two-year follow-up, no recurrence. Two cases, at 2,7 after a relapse again to repeat the treatment and follow-up. One case of recurrence of advanced bladder cancer, with lung and brain metastases, the combination of lung lesions transfer of radioactive seed implantation, brain metastasis γ knife radiotherapy, survived five years. One case of pelvic extensive transfer of patients, treatment after the two refused treatment, died of cancer after six months. One case of a shorter treatment time, in follow-up. Conclusion Preliminary results show that, confirmed the limitations of invasive bladder cancer patients, after the operation, using the internal iliac artery chemotherapy + bladder infusion chemotherapy in the treatment method, can significantly improve the efficacy and effective in reducing Tumor recurrence, significantly reducing the side effects of intravenous chemotherapy and improve the quality of life of patients, patients easily accepted, it is worth further exploration.更多还原