【摘要】 目的极高危非肌层浸润性膀胱癌具有很高的复发和进展风险。明确双侧髂内动脉化疗栓塞术(IAC)经尿道电切术后辅助措施的价值。方法回顾性分析2015年1月至2017年12月收治的该类患者38例,均接受经尿道膀胱肿瘤电切术及术后规律膀胱灌注治疗(卡介苗或表柔吡星/吡柔吡星),根据是否接受IAC分为IAC组及对照组。IAC组在电切术后2周内接受第1疗程IAC,再间隔3～4周行第2疗程IAC,化疗方案:顺铂60 mg/m2,吡柔比星25 mg/m2。术后随访指标包括无复发生存时间、随访期间进展率及切除膀胱率等。结果 IAC组12例,对照组26例,平均随访时间(30.1±12.4)个月。IAC组与对照组在主要观察指标上的比较如下:无复发生存时间(20.3±14.1)个月比(8.9±7.2)个月,(P=0.002),1年无复发生存率66.7%比26.9%,(P=0.02),2年无复发生存率33.3%比7.7%,(P=0.07),随访期间进展率33.3%比46.2%,(P=0.46),切除膀胱率25.0%比46.2%,(P=0.21)。结论对于极高危非肌层浸润性膀胱癌患者,在经尿道电切术后辅助双侧髂内动脉化疗栓塞有助于延缓疾病的复发。更多还原

【Abstract】 Objective Extremely high-risk non-muscle invasive bladder cancer(NMIBC) carries a very high risk of recurrence and progression after trans-urethral resection. The purpose of this study is to clarify whether intra-arterial chemoembolization(IAC) via bilateral internal iliac arteries, which is used as an auxiliary measure after trans-urethral resection of bladder tumor(TURBt), can benefit patients or not. Methods The clinical data of a total of 38 admitted patients with extremely high-risk NMIBC, who received TURBt and subsequent regular intra-vesical perfusion(using BCG vaccine or epirubicin/pirarubicin) during the period from January 2015 to December 2017, were retrospectively analyzed. Depending on whether IAC was adopted or not, the patients were divided into IAC group(n=12) and control group(n=26). For the patients of IAC group,the first course of IAC was performed within 2 weeks after TURBt, and after 3-4 weeks the second course of IAC was carried out. The chemotherapy regimen included cisplatin 60 mg/m2 and pirarubicin 25 mg/m2. After the treatment, the patients were followed up to observe the clinical results, and the recurrence-free survival time, progression rate and cystectomy rate were calculated. Results IAC group had 12 patients, and control group had 26 patients. The mean follow-up time was(30.1±12.4) months. In IAC group and control group, the recurrence-free survival time was(20.3±14.1) months and(8.9±7.2) months respectively(P=0.002), the oneyear recurrence-free survival rate was 66.7% and 26.9% respectively(P=0.02), the 2-year recurrence-free survival rate was 33.3% and 7.7% respectively(P=0.07); and during the follow-up period, the progression rate was 33.3% and 46.2% respectively(P=0.46), the cystectomy rate was 25.0% and 46.2% respectively(P=0.21).Conclusion For the treatment of extremely high-risk NMIBC, TURBt followed by IAC via bilateral internal iliac arteries is helpful for delaying the recurrence of the disease.(J Intervent Radiol, 2020, 29: 988-992)更多还原