Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou, 510080, China.
Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, No.600 Tan He Road, Guangzhou, 510080, China.
J Cancer Res Clin Oncol. 2019 Feb;145(2):487-494. doi: 10.1007/s00432-018-2811-5. Epub 2018 Dec 11.
Comparing intra-arterial chemotherapy combined with intravesical chemotherapy against intravesical chemotherapy alone in the treatment of T1-staged Grade 3 (T1G3) bladder cancer after transurethral resection of bladder tumor (TURBT).
From January 2007 to December 2012, 203 patients diagnosed with NMIBC were randomly assigned into either intra-arterial chemotherapy combined with intravesical chemotherapy group (Group A, n = 68) or intravesical chemotherapy alone group (Group B, n = 135) after TURBT. Four cycles of intra-arterial chemotherapy were administered after initial TURBT with 1-month interval between each. Intravesical chemotherapy was administered in both groups including an immediate 50 mg epirubicin instillation after TURBT and weekly maintenance for 8 weeks, and then followed by monthly maintenance for 1 year. The primary endpoint was recurrence-free survival.
Out of 203 patients, 53 were in Group A and 98 in Group B, and they were evaluated for recurrence and progression rate where recurrence rate was 35.8% (19/53) in group A and 41.8% (41/98) in group B with a significant difference (P < 0.05) and progression rate was 20.7% (11/53) in group A and 23.5% (23/98) in group B with a significant difference (P < 0.05). Univariate and multivariate logistic regression analysis suggested that intra-arterial chemotherapy could be an independent risk factors related to both overall survival and time to first recurrence.
Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in T1G3 bladder cancer.
比较经尿道膀胱肿瘤切除术（TURBT）后，动脉内化疗联合膀胱内化疗与单纯膀胱内化疗治疗 T1 期 3 级（T1G3）膀胱癌的效果。
2007 年 1 月至 2012 年 12 月，203 例非肌层浸润性膀胱癌（NMIBC）患者随机分为动脉内化疗联合膀胱内化疗组（A 组，n=68）和单纯膀胱内化疗组（B 组，n=135）。初始 TURBT 后，每 1 个月进行 1 次 4 个周期的动脉内化疗。两组均在 TURBT 后立即给予 50mg 表柔比星灌注，并进行 8 周的每周维持治疗，然后进行 1 年的每月维持治疗。主要终点是无复发生存率。
203 例患者中，A 组 53 例，B 组 98 例，对其复发和进展率进行了评估，其中 A 组复发率为 35.8%（19/53），B 组为 41.8%（41/98），差异有统计学意义（P<0.05）；A 组进展率为 20.7%（11/53），B 组为 23.5%（23/98），差异有统计学意义（P<0.05）。单因素和多因素 logistic 回归分析表明，动脉内化疗是总生存时间和首次复发时间的独立危险因素。
与单纯膀胱内化疗相比，动脉内化疗联合膀胱内化疗可降低 T1G3 膀胱癌的复发和进展风险。
