Galetti T P, Pontes J E, Montie J, Medendorp S V, Bukowski R
Department of Urology, Cleveland Clinic Foundation, Ohio.
J Urol. 1989 Nov;142(5):1211-4; discussion 1214-5. doi: 10.1016/s0022-5347(17)39031-6.
The long-term results of regional chemotherapy plus intra-arterial cisplatin with or without doxorubicin as an adjuvant before cystectomy and urinary diversion in patients with invasive transitional cell carcinoma of the bladder were evaluated. A total of 27 patients with T3aNxMo (8), T3bNxMo (14) and T4NxMo (5) disease participated in a phase II trial completed in 1985. Of the patients 19 received cisplatin and doxorubicin intra-arterially, and cyclophosphamide intravenously, and the remaining 8 received 70 to 100 mg. per m.2 cisplatin intra-arterially. A total of 19 patients underwent cystectomy after chemotherapy. Patients in this group had a pathological complete response (no evidence of disease after surgical restaging) or the presence of residual disease at operation that could (surgical complete response) or could not (pathological partial response) be completely resected. Of the 19 patients undergoing cystectomy surgical complete response was observed in 47.4%, pathological complete response in 26.3% and pathological partial response in 26.3%. At a median followup of 27 months for the group 66% of the patients with a surgical complete response, 100% with a pathological complete response and 40% with a pathological partial response were alive with no evidence of disease. The over-all survival for patients with a pathological or surgical complete response is 76.9%. In the patients not operated upon because of persistent or advanced disease after chemotherapy survival was brief (less than 4 months). Prolonged survival in patients achieving a pathological or surgical complete response with neoadjuvant chemotherapy occurs, and this modality may have a role in patients with invasive tumors.
对采用区域化疗联合动脉内顺铂（加或不加阿霉素）作为膀胱浸润性移行细胞癌患者膀胱切除术和尿流改道术之前的辅助治疗的长期结果进行了评估。共有27例患有T3aNxMo（8例）、T3bNxMo（14例）和T4NxMo（5例）疾病的患者参与了一项于1985年完成的II期试验。其中19例患者动脉内给予顺铂和阿霉素，静脉内给予环磷酰胺，其余8例患者动脉内给予每平方米体表面积70至100毫克顺铂。共有19例患者在化疗后接受了膀胱切除术。该组患者有病理完全缓解（手术重新分期后无疾病证据）或术中存在可完全切除（手术完全缓解）或不可完全切除（病理部分缓解）的残留疾病。在接受膀胱切除术的19例患者中，观察到手术完全缓解率为47.4%，病理完全缓解率为26.3%，病理部分缓解率为26.3%。该组患者的中位随访时间为27个月，手术完全缓解的患者中有66%存活且无疾病证据，病理完全缓解的患者中有100%存活且无疾病证据，病理部分缓解的患者中有40%存活且无疾病证据。病理或手术完全缓解患者的总体生存率为76.9%。在因化疗后疾病持续或进展而未接受手术的患者中，生存期较短（不到4个月）。新辅助化疗使患者达到病理或手术完全缓解后生存期延长，这种治疗方式可能对浸润性肿瘤患者有作用。
