摘要
目的 探讨表阿霉素髂内动脉化疗预防膀胱癌术后复发的治疗效果。 方法 高危膀胱移行细胞癌保留膀胱手术 86例 ,其中 31例行表阿霉素髂内动脉化疗 ,5 5例未行化疗 ,用Cox模型分析方法筛选出肿瘤复发的相关因素 ,并用Kaplan Merier无瘤生存曲线分析方法对两组进行对比分析。 结果 髂内动脉化疗组 9/31(2 9% )术后复发明显低于未化疗组的 30 /5 5 (5 4 % ) (P <0 .0 0 1)。两组复发患者的复发时间分别为 14 .2和 10 .4个月。化疗组复发患者有 2例接受了根治性膀胱全切手术 ,未化疗组有 9例行根治性膀胱全切手术。多次复发伴细胞升级的肿瘤和术后髂内动脉化疗是影响肿瘤再次复发的显著因素 ,前者为危险因素 ,后者为保护因素 (P <0 .0 0 1)。 结论 膀胱移行细胞癌术后行表阿霉素髂内动脉化疗可以减低术后复发率、延长无瘤生存时间和降低根治性膀胱全切手术的危险性。
Objective To summarize the efficacy of epirubicin chemotherapy by intra-iliac arteral infusion for the high risk patients of postoperative bladder cancer. Methods Eighty-six patients with the bladder cancer at high risk of recurrence who had undergone the bladder-sparing surgery were divided into two groups.Thirty-one patients were treated by intra-iliac arterial infusion chemotherapy of epirubicin and the remaining 55 patients had no chemotherapy.An analysis on recurrence related factors was made by multivariate Cox regression analysis models.And Kaplan-Meier curves were compared using the log-rank test on the disease-free between the two groups. Results Multi-recurrence associated with a higher grade and postoperative intra-iliac arterial infusion chemotherapy of epirubicin were significantly important factors,the former being risk factor and the latter being protective factor of cancer recurrence in bladder respectively.The recurrence of 9 in 31 patients (29%) with intra-iliac arterial infusion chemotherapy of epirubicin was significantly lower than that of 30 in 55 patients (54%) without chemotherapy ( P <0.001).The median disease-free periods of the 2 groups were 14.2 and 10.4 months,respectively.Two and 9 patients in the 2 groups with and without intra-iliac arterial infusion chemotherapy of epirubicin received the radical cystectomy. Conclusions Postoperative intra-iliac arterial infusion chemotherapy of epirubicin may improve the prognosis of bladder cancer in decreasing the recurrence, prolonging the disease-free survival and reducing the risk of radical cystectomy.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2003年第9期617-619,共3页
Chinese Journal of Urology
关键词
膀胱癌
术后
复发
表阿霉素
髂内动脉化疗
Bladder neoplasms
Carcinoma
Intra-iliac arterial
Chemotherapy
Epirubicin
