新辅助化疗联合高-低氧吸入放射治疗浸润性膀胱癌的研究(1)
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【摘要】 目的 评估新辅助化疗联合高-低氧吸入放射治疗浸润性膀胱癌的疗效及安全性。方法 对31 例无法耐受或拒绝接受膀胱全切手术的浸润性膀胱癌患者进行保留膀胱治疗,先给予新辅助化疗2周期,然后给予盆腔适形放疗,放疗过程中先后吸入高低浓度氧。对肿瘤部分缓解及复发患者行保留膀胱的手术。结果 肿瘤完全缓解率为71.0%(22/31),部分缓解率29.0 %(9/31)。9例部分缓解的患者接受了保留膀胱的手术治疗,4例复发患者接受了再次手术治疗。结论 新辅助化疗联合高-低氧吸入放疗为部分无法耐受或拒绝接受膀胱全切术的浸润性膀胱癌患者提供了一种有效的治疗方法。
【关键词】 膀胱癌;化学治疗;放射治疗;氧
The study of neoadjuvant chemotherapy and radiotherapy with inspiring high and low concentration oxygen respectively in invasive bladder cancer
SUN Yan-wei,YIN Qiang,CHI Yu-hua,et al.Department of Medical Oncology,Rizhao city People’s hospital,Rizhao 276800,China
【Abstract】 Objective To study the efficacy of neoadjuvant chemotherapy plus radiotherapy with inspiring high and low concentration oxygen respectively in invasive bladder cancer. Methods All 31 patients with invasive bladder cancer underwent bladder sparing treatment,who rejected or could not bear total cystectomy. The neoadjuvant treatment protocol consisted of chemotherapy two cycles and radiotherapy with inspiring high and low concentration oxygen respectively. Those patients who obtained partial response or recurred in the follow-up period were treated with bladder sparing operation. Results After neoadjuvant therapy,22 patients (71.0 %) showed a complete response (CR) and 9 patients (29.0 %) showed a partial response (PR). Total nine patients accepted extensive transurethral resection or partial cystectomy,one of four cases accepted the second operation due to local recurrence. Conclusion Neoadjuvant chemotherapy and radiotherapy with inspiring high and low concentration oxygen respectively is an effective method for partial patients with invasive bladder cancer,especially for those who can not tolerate burden or reject total cystectomy.
【Key words】 Bladder neoplasms; Chemotherapy; Radiotherapy; Oxygen
目前浸润性膀胱癌的治疗较趋向于采用保留膀胱生理功能的手术。研究发现,新辅助化疗联合放疗能使膀胱肿瘤缩小并降期,从而增加了保存功能性膀胱的手术机会[1]。国内研究发现,高-低氧吸入放疗的疗效优于单纯放疗[2,3]。本科自2003年4月至2006年3月对31例无法耐受或拒绝接受膀胱全切术的浸润性膀胱癌患者,采用了新辅助化疗联合高-低氧吸入放疗的方法,效果满意,现报告如下。
1 资料与方法
1.1 临床资料 所有患者均符合下列条件:经膀胱镜活检证实为浸润性膀胱癌;有全膀胱切除手术指征;因合并其他疾病不能耐受或拒绝行全膀胱切除手术者;无远处转移;无盆腔放疗史;对治疗方案知情同意。入组31例,男24例,女7例。年龄56～82岁,平均67.7岁。年龄>75岁者5例。肿瘤直径2.1～7.3 cm,平均为4.7 cm。4例患者合并严重的心、脑血管疾病,3例患者主动要求保留膀胱。其中鳞癌4例、腺癌3例、混合性癌2例、移行细胞癌18例、小细胞癌1例、乳头状癌3例 ......
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