Bolla M, Faure G, Chirpaz A, Martin H, Vrousos C, Revol M
J Urol (Paris). 1981;87(9):625-9.
Basing their indications on the histo-prognosis of Opperman and Bittard in malignant tumours of the bladder, the authors decided to irradiate before cystectomy those bladder tumours in which the histo-prognostic index indicated that it was a local disease with metastatic potential with a spontaneous life expectancy of 18 to 30 months. Radiotherapy was given spread over 23 or 27 fractions providing a total of 46 Gy. Four to 6 weeks later, cystoprostatectomy with trans-ileal cutaneous ureterostomy was performed, before chemotherapy for one year. Amongst 11 patients treated, in 6 cases the bladder was completely "sterilised" from a histological standpoint. However there was persistence of tumour in 5 bladders with an increase in the histo-prognostic index. Amongst these 11 patients, with a minimum follow-up of 18 months, there has been a pelvic recurrence in two cases and three developed fatal metastases. In the opinion of the authors, these preliminary results represent an encouragement to continue along the same lines.
作者依据奥珀曼（Opperman）和比塔尔德（Bittard）对膀胱恶性肿瘤的组织学预后判断来确定治疗指征，决定在膀胱切除术之前，对那些组织学预后指数表明为具有转移潜能的局部疾病、自然预期寿命为18至30个月的膀胱肿瘤进行放疗。放疗分23次或27次进行，总计46 Gy。4至6周后，进行膀胱前列腺切除术并做经回肠皮肤输尿管造口术，随后进行为期一年的化疗。在接受治疗的11例患者中，从组织学角度来看，6例患者的膀胱完全“清除”肿瘤。然而，5例患者的膀胱中仍有肿瘤残留，且组织学预后指数有所上升。在这11例患者中，最短随访时间为18个月，2例出现盆腔复发，3例发生致命转移。作者认为，这些初步结果为沿相同路线继续治疗提供了鼓励。
