Ikushima Hitoshi, Iwamoto Seiji, Osaki Kyohsuke, Furutani Shunsuke, Yamashita Kyoh, Kawanaka Takashi, Kubo Akiko, Takegawa Yoshihiro, Kudoh Takaharu, Kanayama Hiroomi, Nishitani Hiromu
Department of Radiology, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
Radiat Med. 2008 Apr;26(3):156-63. doi: 10.1007/s11604-007-0211-x.
The aim of this study was to evaluate retrospectively the toxicity and response, bladder preservation, and survival of patients with muscle-invasive bladder cancer treated with multimodality therapy consisting of low-dose radiation therapy (RT) and concurrent intraarterial chemotherapy (IACT).
. Between November 1999 and July 2005, a total of 27 consecutive, previously untreated patients with muscle-invasive bladder cancer underwent transurethral bladder tumor resection followed by concurrent low-dose RT and IACT. Patients who achieved a complete response (CR) were followed up closely without further therapy, and patients who did not achieve a CR underwent further treatment.
Complete response was achieved in 22 of 27 patients (81%). Of these 22 patients, 7 developed recurrences, and 3 died of their disease. In five patients who did not achieve CR, one died from bone metastases. The 3-year overall survival rate was 81%, with a median follow-up time of 27 months; and 22 of 27 patients (81%) with a preserved bladder were tumor-free at the last follow-up. Three patients (11%) developed grade 3 acute hematological toxicity.
Multimodality therapy consisting of low-dose RT and concurrent IACT for muscle-invasive bladder cancer can achieve survival rates similar to those in patients treated with radical cystectomy, with successful bladder preservation and minimal adverse effects.
本研究旨在回顾性评估接受低剂量放射治疗（RT）和同期动脉内化疗（IACT）组成的多模式治疗的肌层浸润性膀胱癌患者的毒性和反应、膀胱保留情况及生存率。
1999年11月至2005年7月期间，共有27例连续的、先前未接受过治疗的肌层浸润性膀胱癌患者接受了经尿道膀胱肿瘤切除术，随后接受同期低剂量RT和IACT。达到完全缓解（CR）的患者密切随访，不再接受进一步治疗，未达到CR的患者接受进一步治疗。
27例患者中有22例（81%）达到完全缓解。在这22例患者中，7例出现复发，3例死于疾病。在5例未达到CR的患者中，1例死于骨转移。3年总生存率为81%，中位随访时间为27个月；27例膀胱保留患者中有22例（81%）在最后一次随访时无肿瘤。3例患者（11%）出现3级急性血液学毒性。
由低剂量RT和同期IACT组成的多模式治疗对于肌层浸润性膀胱癌可实现与根治性膀胱切除术患者相似的生存率，成功保留膀胱且不良反应最小。
