摘要
目的探讨术前动脉化疗栓塞联合膀胱内灌注对Ta～T1期浅表性膀胱癌复发和生存期的影响。方法选择2002年1月～2012年6月间在湖州市第一人民医院治疗的Ta～T1期60例浅表性膀胱癌患者随机分为两组。A组(动脉化疗栓塞组)30例,在膀胱动脉化疗栓塞后15天经尿道膀胱肿瘤电切术,电切术后24h行膀胱腔内化疗药物灌注。B组(未动脉化疗栓塞组)30例,经尿道膀胱肿瘤电切术,电切术后24h行膀胱腔内化疗药物灌注。两组病例随访时间为入院治疗开始至2012年6月30日止。结果 2年复发率:A组(4/30,13.3%)、B组(7/30,23.3%),A组少于B组,差异有统计学意义(χ2=27.6,P<0.005);5年生存率A组(96.7%,29/30)略高于B组(86.7%,26/30),差异没有统计学意义(χ2=2.22,P>0.05);肿瘤进展率A组3.3%,B组进展率13.3%,差异无显著性意义(χ2=2.22,P>0.05);7年生存率A组(76.7%,23/30)高于B组(46.7%,18/30),差异有统计学意义(χ2=5.711,P=0.017)、中位无复发期A组(27个月)高于B组(10个月),组间差异有统计学意义(χ2=7.596,P=0.006)、两组复发患者无瘤生存期:A组21.5±5.0个月高于B组15.7±5.7个月(t=3.816,P=0.001)。结论术前动脉化疗栓塞联合经尿道膀胱肿瘤电切术和膀胱腔内灌注化疗能有效延缓Ta～T1期浅表性膀胱癌的复发,提高患者的生存期。
Objective To investigate the effect of preoperative arterial chemoembolization combined with intravesical instillation on the recurrence and survival of superficial bladder cancer of Ta - T1. Methods Totally 60 cases diagnosed superficial bladder cancer of Ta ～ T1 in the First People＇s Hospital of Huzhou from January 2002 to June 2012 were randomly assigned into two groups. After 15 days of arterial chemoembolization, 30 cases of group A underwent transurethral resection of bladder tumor（TURBt） , 24 hours later, performed with intravesieal instillation. After 24 hours of TURBt,30 cases of group B underwent intravesical instillation. The follow -up time of two groups ended until June 30, 2012. Results The 2 - year recurrence of group A was 13.3% （4/30） , group B was 23.3% （7/30） , the difference between them had statistical significance （X^2 = 27.6, P 〈 0. 005 ） ;the 5 - year survival rate of group A （96.7% ,29/30） was a little higher than that of group B （86.7% , 26/30） , total 5 - year progression rate of group A was 3.3% , group B 13.3% ,but the differences had no significance （X^2 = 2.22,P 〉 0.05）. The 7 -year survival rate of group A （76.7% , 23/30） was superior than group B （46.7% ,14/30） , the median time of no recurrence of group A （27 months） is longer than group B （l0 months） ,the differences were statistically significant （X^2 = 5.711 ,P = 0. 017 ;X^2 = 7. 596,P = 0. 006）. The survival time without tumor of cases in two groups ： group A （21.5±5.0） monthswas higher than that of group B （15.7±5.7） months （t= 3.816, P=0.001）. Conclusion Preoperative arterial ehemoembolization combined with TURBt and intravesical instillation can effectively delay the recurrence of superficial bladder cancer Ta -Ti, and improve the survival.
出处
《医学研究杂志》
2013年第5期109-113,共5页
Journal of Medical Research
基金
浙江省科技计划项目(2012KYB199)
获2012年浙江省医药卫生科技创新三等奖
关键词
膀胱癌
化疗栓塞
Bladder cancer
Chemotherapy and embolization
