Fosså S D, Dingsør E, Johannessen N B, Kvarstein B, Stenwig A E, Urnes T, Waehre H, Ogreid P
Scand J Urol Nephrol. 1987;21(1):39-42. doi: 10.3109/00365598709180288.
Fourteen patients with muscle infiltrating bladder cancer in whom total cystectomy was planned, received 3 cycles of cis-platinum (70 mg/m2 Day 1) and Methotrexate (40 mg/m2 Day 1) with 3-week intervals before pelvic radiotherapy (20 Gy). Thirteen patients underwent cystectomy whereas the remaining patient finally was found to be inoperable. The subjective toxicity (nausea, vomiting, decrease of performance status), the hematological side effects and the nephrotoxicity of this pre-cystectomy treatment were acceptable. In particular, the treatment did not increase the per- and postoperative complication rate as long as patients were selected who were good risk candidates for major surgery. Stage reduction (P less than T) was seen in 9 of 13 patients. Combination therapy with cis-platinum/methotrexate and short term pelvic radiotherapy is feasible as adjuvant pre-cystectomy treatment in patients with muscle infiltrating bladder cancer. The possible therapeutic superiority of this adjuvant treatment has to be shown in randomized trials.
计划接受全膀胱切除术的14例肌肉浸润性膀胱癌患者，在盆腔放疗（20 Gy）前，每3周接受3个周期的顺铂（70 mg/m²，第1天）和甲氨蝶呤（40 mg/m²，第1天）治疗。13例患者接受了膀胱切除术，而其余1例患者最终被发现无法手术。这种膀胱切除术前治疗的主观毒性（恶心、呕吐、体能状态下降）、血液学副作用和肾毒性是可以接受的。特别是，只要选择的患者是重大手术的良好风险候选者，该治疗就不会增加围手术期和术后并发症发生率。13例患者中有9例出现分期降低（P小于T）。顺铂/甲氨蝶呤联合治疗和短期盆腔放疗作为肌肉浸润性膀胱癌患者膀胱切除术前的辅助治疗是可行的。这种辅助治疗可能的治疗优势必须在随机试验中得到证实。
