[1]肖春雷,田晓军,李选,等.经尿道膀胱肿瘤电切术后单次髂内动脉栓塞化疗治疗难治性膀胱癌[J].中国微创外科杂志,2006,06(12):973-974.
　Xiao Chunlei*,Tian Xiaojun*,Li Xuan,et al.Single-dose intra-arterial infusion chemotherapy for refractory bladder cancer after transurethral resection of bladder tumor:Report of 12 cases[J].Chinese Journal of Minimally Invasive Surgery,2006,06(12):973-974.
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经尿道膀胱肿瘤电切术后单次髂内动脉栓塞化疗治疗难治性膀胱癌()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年12期
页码:
973-974
栏目:
出版日期:
2006-12-30

文章信息/Info

Title:
Single-dose intra-arterial infusion chemotherapy for refractory bladder cancer after transurethral resection of bladder tumor:Report of 12 cases
作者:
肖春雷; 田晓军; 李选; 曲雯; 卢剑; 庄申榕; 陈忠新; 黄毅; 马潞林
北京大学第三医院泌尿外科,北京,100083
Author(s):
Xiao Chunlei*;  Tian Xiaojun*;  Li Xuan;  et al.
*Department ofUrology, Peking University ThirdHospital, Beijing100083, China
关键词:
膀胱肿瘤; 癌; 经尿道膀胱肿瘤电切术; 化疗
Keywords:
Bladder neoplasm; 　Carcinoma; 　TURBt; 　Chemotherapy
分类号:
R737.14;R453
文献标志码:
A
摘要:
目的 探讨经尿道膀胱肿瘤电切术后单次髂内动脉栓塞化疗对难治性膀胱癌的疗效.方法 1999年11月～2005年6月,对12例难治性膀胱癌应用经尿道膀胱肿瘤电切(transurethral resection of bladder tumor,TURBt)术后加用髂内动脉栓塞化疗.先经尿道将膀胱肿瘤完整切除,术后1周行双侧髂内动脉造影,采用Seldinger技术,经右侧股动脉插管,明确正常血供与肿瘤血管,然后向双侧髂内动脉各注入半量化疗药物(表阿霉素各25 mg),再超选择至膀胱肿瘤血管注入末梢栓塞剂(即化疗栓塞剂,为明胶海绵碎块与顺铂200 mg之混合物),可反复栓塞,直至所有肿瘤血管化疗栓塞满意为止.术后常规用表阿霉素膀胱灌注,每3个月复查膀胱镜.结果 动脉栓塞化疗后,12例均有恶心、食欲不振,呕吐3例,发热2例,经对症处理缓解.臀部轻度疼痛6例,3～5日缓解.血红细胞、白细胞减少4例,对症处理2周后正常.肝肾功能无明显变化.随访4～55个月,平均34个月.1例术后12个月复发,其余11例无瘤生存.结论 此种方法治疗难治性膀胱癌的复发率低、副作用小,为不愿行膀胱全切的患者提供了一种新的选择.
Abstract:
Objective　To evaluate clinical effects of single-dose intra-arterial infusion chemotherapy for the treatment of refractory bladder cancer after transurethral resection of bladder tumor (TURBt).　M ethods　A retrospective analysiswasmade on clinical data of 12 cases of refractory bladder cancer treated by single-dose intra-arterial infusion chemotherapy after TURBt from November1999 to June 2005. The bladder tumorwas resected as thoroughly as possible. Postoperatively, a bilateral internal iliac arteriographywasmade by using the Seldinger technique. The tumor vessels and normal blood supply were identified through the intubation of the right femoral artery. Half dose of chemotherapeutics (epirubicin 25 mg) was infused into both internal iliac artery, then tumor vessels of bladderwas selected and infused with peripheral embolization agent (a mix of fragmented gelatin sponge and cisplatin 200 mg). The embolization agentwas used repeatedly until all tumor vessels were embolized. Intravesical instillation with epirubicin was carried outpostoperatively, and cystoscopywas performed every3months afteroperation.　Results　After intra-arterial infusion chemotherapy, therewere 12 cases ofnausea and anepithymia, 3 cases of vomiting, and 2 cases of fever, all ofwhich were symptomatically relieved with expectant treatment. Mild hip pain occurred in 6 cases and subsided in 3~5 days. Decreased erythrocyte and leucocytewere restored to normal levels in 2 weeks. Liver and renal functions did not presentmarked changes. Follow-up was conducted for4~55 months (mean, 34 months). There were 1 case of recurrence at 32 postoperative month and 11 cases of progression free surviva.l　Conclusions　This technique lowers the recurrent rate of refractory bladder cancer and the incidence of side effects, being a new alternative for patientswho are notwilling to receive total cystectomy.

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更新日期/Last Update: 2014-03-03