Utsunomiya M, Itoh H, Yoshioka T, Masaki N, Itatani H
Department of Urology, Sumitomo Hospital, Japan.
Br J Urol. 1992 Oct;70(4):399-403. doi: 10.1111/j.1464-410x.1992.tb15796.x.
Between March 1981 and March 1990, 15 patients with locally advanced transitional cell carcinoma of the bladder were treated concurrently with cisplatin and radiotherapy. Treatment comprised a radiation dose of 40-50 Gy in 20-25 fractions over 4-5 weeks and intravenous infusion of cisplatin with hydration during days 1-5 and 22-26. The total scheduled dose of cisplatin was 200 mg. A complete response (CR) was seen in 3 patients (2 T2 tumours and 1 T3) and the other 12 were regarded as partial responders. Two of the 12 partial responders (1 T2 tumour and 1 T4) underwent cystectomy after treatment, but 9 patients (2 T2, 6 T3 and 1 T4) underwent only transurethral resection. The remaining patient (with a T4 tumour) died from systemic disease, further treatment not being possible because of unrelated heart failure. In 3 CR patients and 9 with a partial response (PR), bladder function was preserved and they have survived for a mean of 18.3 months (range 5-47) after therapy. Although 4 patients in this group had recurrent bladder tumours and 1 died from cancer in another part of the body, 7 have survived with normal bladder function and no recurrence. It is concluded that concurrent cisplatin and radiation therapy is a safe and viable regimen and may be considered as a means of preserving the bladder in patients with locally advanced transitional cell carcinoma.
1981年3月至1990年3月期间，15例局部晚期膀胱移行细胞癌患者同时接受顺铂和放疗。治疗包括在4 - 5周内分20 - 25次给予40 - 50 Gy的放射剂量，以及在第1 - 5天和第22 - 26天静脉输注顺铂并进行水化。顺铂的预定总剂量为200 mg。3例患者（2例T2肿瘤和1例T3肿瘤）出现完全缓解（CR），其他12例被视为部分缓解者。12例部分缓解者中的2例（1例T2肿瘤和1例T4肿瘤）在治疗后接受了膀胱切除术，但9例患者（2例T2、6例T3和1例T4）仅接受了经尿道切除术。其余患者（患有T4肿瘤）死于全身性疾病，由于无关的心力衰竭无法进行进一步治疗。在3例完全缓解患者和9例部分缓解（PR）患者中，膀胱功能得以保留，治疗后平均存活18.3个月（范围5 - 47个月）。尽管该组中有4例患者出现膀胱肿瘤复发，1例死于身体其他部位的癌症，但7例患者存活且膀胱功能正常，无复发。结论是，顺铂与放疗联合治疗是一种安全可行的方案，可被视为局部晚期膀胱移行细胞癌患者保留膀胱的一种方法。
