Bichler K H, Flüchter S H, Steimann J, Strohmaier W L
Department of Urology, University of Tübingen, FRG.
Urol Int. 1989;44(1):10-4. doi: 10.1159/000281441.
The intravenous administration of cytostatics in cases of locally extended carcinomas of the bladder seems to promise success. As concomitant disadvantage however we have to mention that the drugs in high concentrations needed for this treatment give rise to systemic toxic effects limiting the rational use of the drug. A further rise of cytostatic tissue concentration seems possible by performing a synchronous tumor injection of cytostatics and microspheres. An additional anticancer effect and the synergistic activation of cytostatic effectivity must be assumed by a following local transurethral high-frequency hyperthermia of the bladder. Our first urological experiences with this integrated therapy in six locoregional (T3-4N0M0) and six advanced metastasizing (T3-4N1M0-1) bladder cancers are presented consisting of a combined intraarterial cytostatic microspheres carcinoma infusion (CMCI) and scheduled adjunctive transurethral high-frequency hyperthermia (TUHH). In the case of locoregional tumor the aim was cancer destruction or debulking and in the case of metastasizing tumor palliation of local disease. Mechanisms of action, methodical procedures, indications, results as well as side effects of the intraarterial CMCI and TUHH treatment as developed by our department are presented and discussed.
对于局部进展期膀胱癌患者，静脉注射细胞抑制剂似乎有望取得成功。然而，作为伴随的不利因素，我们必须提到，这种治疗所需的高浓度药物会产生全身毒性作用，限制了药物的合理使用。通过同步进行细胞抑制剂和微球的肿瘤内注射，似乎有可能进一步提高细胞抑制剂在组织中的浓度。通过随后对膀胱进行局部经尿道高频热疗，必须假定具有额外的抗癌作用以及细胞抑制效力的协同激活。本文介绍了我们在6例局部区域（T3 - 4N0M0）和6例晚期转移性（T3 - 4N1M0 - 1）膀胱癌患者中采用这种综合治疗的首批泌尿外科经验，该治疗包括联合动脉内细胞抑制微球癌灌注（CMCI）和预定的辅助经尿道高频热疗（TUHH）。对于局部区域肿瘤，目标是破坏癌症或减少肿瘤体积；对于转移性肿瘤，目标是缓解局部疾病。本文介绍并讨论了我们科室开展的动脉内CMCI和TUHH治疗的作用机制、方法步骤、适应症、结果以及副作用。
