Miyanaga N, Ohtani M, Noguchi R, Uchida K, Akaza H, Koiso K, Tatsuzaki H, Ohara K, Tsuji H, Inada T
Department of Urology, University of Tsukuba.
Nihon Hinyokika Gakkai Zasshi. 1991 Oct;82(10):1583-7. doi: 10.5980/jpnjurol1989.82.1583.
Fifteen patients with invasive bladder cancer were treated with selective intra-arterial cisplatin and external beam radiotherapy (30.6 Gy over 3 weeks) prior to a planned cystectomy. Cisplatin, in total 200 mg, was administered via bilateral internal iliac artery infusion during the course of radiotherapy. Seven patients were evaluated for local response. Partial response (PR) was revealed in 4, and minor response (MR) in 3. Ten patients received total cystectomy, and pathological effects by the criteria adipted by Japanese Urological Association and The Japanese Society of Pathology, were as follows: Ef. 3 in 1 case, Ef. 2 in 6. Ef. 1b in 1 and Ef. 1a in 2. Down staging was observed in 8 patients from the clinical to the pathological stage. Thirteen patients are alive for 21 months. Two patients have died (1 lung infarction, 1 pancreatic cancer). Though nausea and sciatica-like pain were observed in some cases, there was no severe systemic side effects such as bone marrow suppression and renal toxicity. From these results it is concluded that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated.
15例浸润性膀胱癌患者在计划行膀胱切除术之前，接受了选择性动脉内顺铂治疗及外照射放疗（3周内给予30.6 Gy）。在放疗过程中，通过双侧髂内动脉灌注共给予顺铂200 mg。对7例患者进行了局部反应评估，其中4例显示部分缓解（PR），3例显示轻微缓解（MR）。10例患者接受了全膀胱切除术，根据日本泌尿外科学会和日本病理学会采用的标准，病理结果如下：效应3级1例，效应2级6例，效应1b级1例，效应1a级2例。8例患者从临床分期降至病理分期。13例患者存活21个月。2例患者死亡（1例死于肺梗死，1例死于胰腺癌）。尽管在某些病例中观察到恶心和坐骨神经痛样疼痛，但未出现骨髓抑制和肾毒性等严重的全身副作用。从这些结果可以得出结论，这种治疗方式在全膀胱切除术候选者的术前检查中可能有效，并且在全膀胱切除术禁忌的患者治疗中也可能有用。
