Mori Ken-ichi, Nomata Koichiro, Noguchi Mitsuru, Eguchi Jiro, Hayashi Nobuyuki, Kanetake Hiroshi
Division of Nephro-Urology, Department of Translational Medical Sciences, Course of Medical and Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.
Int J Urol. 2007 Jul;14(7):591-4. doi: 10.1111/j.1442-2042.2007.01780.x.
Combined cisplatin-based intra-arterial chemotherapy and radiotherapy is an effective treatment for patients with locally invasive bladder carcinoma. We report long-term follow-up data regarding definitive treatment of locally invasive bladder carcinoma, regardless of whether bladder preservation was possible.
The follow-up data from 24 patients (18 males and six females; aged, 31-85 years; median, 73 years) with invasive bladder carcinoma, between 1993 and 2003, was examined. The clinical stages of the patients ranged T2-T4, all N0M0, and involved 13 patients at T2 (T2a, T2b), seven patients at T3 and four patients at T4. Combined cisplatin-based intra-arterial chemotherapy and radiotherapy was performed.
The 5-year overall survival rate and cancer-specific survival rate for all patients were 81.6% and 85.6%, respectively. When the patients were divided into complete response (CR) of 10 patients and non-CR groups of 14 patients, the 5-year overall survival rate for the CR group was 87.5%, while that of the non-CR group was 78.6% (P = 0.58). The tumor grade of the CR group was significantly lower than that of the non-CR group (P = 0.01). When the non-CR group was divided into radical cystectomy and non-radical cystectomy groups, the 5-year overall survival rate for the radical cystectomy group (100%) was higher than that of the non-radical cystectomy group (70%).
This combined chemo-radiotherapy was effective for local invasive bladder carcinoma, leading to the possibility of bladder preservation using this therapy.
基于顺铂的动脉内化疗联合放疗是局部浸润性膀胱癌患者的有效治疗方法。我们报告了关于局部浸润性膀胱癌确定性治疗的长期随访数据，无论是否能够保留膀胱。
对1993年至2003年间24例（18例男性和6例女性；年龄31 - 85岁；中位年龄73岁）浸润性膀胱癌患者的随访数据进行了检查。患者的临床分期为T2 - T4，均为N0M0，其中T2期（T2a、T2b）13例，T3期7例，T4期4例。采用了基于顺铂的动脉内化疗联合放疗。
所有患者的5年总生存率和癌症特异性生存率分别为81.6%和85.6%。将患者分为10例完全缓解（CR）组和14例非CR组，CR组的5年总生存率为87.5%，而非CR组为78.6%（P = 0.58）。CR组的肿瘤分级显著低于非CR组（P = 0.01）。将非CR组分为根治性膀胱切除术组和非根治性膀胱切除术组，根治性膀胱切除术组的5年总生存率（100%）高于非根治性膀胱切除术组（70%）。
这种放化疗联合治疗对局部浸润性膀胱癌有效，使得使用该疗法保留膀胱成为可能。
