Russell K J, Koh W J, Russell A H, Griffin B R, Markette K L, Tong D Y, Griffin T W
Department of Radiation Oncology, University of Washington, Seattle.
J Urol. 1989 Jan;141(1):30-2. doi: 10.1016/s0022-5347(17)40577-5.
A total of 17 patients with superficial transitional cell carcinoma of the bladder underwent treatment with pelvic external beam irradiation followed by an intracavitary 137cesium implant via a triple lumen Foley catheter. Of these patients 11 had recurrent and multifocal superficial cancer, with 8 having relapse after prior intravesical chemotherapy. External beam doses of 3,600 to 5,066 cGy. were followed by implant doses delivering 2,000 to 3,200 cGy. to the bladder mucosa, with the sum of external and intracavitary doses totaling 6,500 to 7,500 cGy. Of 15 patients evaluable with a median followup of 48 months, and including 13 followed for more than 2 years, 11 (73 per cent) remain free of disease, 3 (20 per cent) have recurrence in the bladder but have retained the bladder and only 1 has required cystectomy. All 4 failures occurred in the subgroup of 8 patients who had received prior intravesical chemotherapy. This bladder-sparing approach is well tolerated, is an alternative to cystectomy in patients with recurrent superficial transitional cell carcinoma of the bladder and in our series has salvaged 50 per cent (4 of 8) of the patients even after failure of intravesical chemotherapy.
共有17例膀胱浅表性移行细胞癌患者接受了盆腔外照射治疗，随后通过三腔Foley导管进行腔内137铯植入。在这些患者中，11例患有复发性多灶性浅表癌，其中8例在先前膀胱内化疗后复发。外照射剂量为3600至5066 cGy。随后腔内植入剂量为膀胱黏膜提供2000至3200 cGy，外照射和腔内照射剂量总和为6500至7500 cGy。15例可评估患者的中位随访时间为48个月，其中13例随访超过2年，11例（73%）无疾病复发，3例（20%）膀胱复发但保留了膀胱，只有1例需要膀胱切除术。所有4例治疗失败均发生在8例先前接受过膀胱内化疗的患者亚组中。这种保留膀胱的方法耐受性良好，是膀胱复发性浅表性移行细胞癌患者膀胱切除术的替代方法，在我们的系列研究中，即使在膀胱内化疗失败后，也挽救了50%（8例中的4例）的患者。
