Monzen Y, Mori H, Matsumoto S, Takaki H, Yoshida S, Wakisaka M, Ueda S, Mizoguchi H, Ogata J, Kato Y
Department of Radiology, Oita Medical University, Japan.
Radiat Med. 1995 May-Jun;13(3):149-52.
We evaluated the clinical efficacy of treating urinary bladder cancer by intraarterial infusion of cisplatin using an implanted reservoir with and without preoperative concurrent radiation. No previous reports have compared the results obtained by these two methods of treatment. Twenty-three patients with bladder cancer were treated by intraarterial infusion of cisplatin using an implanted reservoir with (n = 13) and without (n = 10) concurrent radiation. The cisplatin plus radiation group received intraarterial cisplatin at a total dose of 200-400 mg and concurrent radiation to a total dose to 30 Gy. The cisplatin group received intraarterial cisplatin at a total dose of 100-600 mg. In the cisplatin plus radiation group, the overall tumor response rate was 92%. Seven of 13 (53%) patients obtained complete response (CR), and the 2-year actuarial survival rate was 92%. Only one of the seven complete responders has had a local recurrence. In the cisplatin group, the overall tumor response rate was 90%. Four of 10 (40%) patients obtained CR, and median survival was 8 months. Three of the four complete responders have had local recurrence. There was no significant difference between these two groups in the frequency of side effects. Concurrent radiation therapy with intraarterial cisplatin resulted in a very low rate of recurrence of bladder cancer compared with intraarterial cisplatin therapy alone. This method was useful for urinary bladder cancer and may become the treatment of choice for this type of cancer.
我们评估了使用植入式储液器经动脉灌注顺铂治疗膀胱癌的临床疗效，对比了术前联合放疗和不联合放疗两种情况。此前尚无报告比较过这两种治疗方法的结果。23例膀胱癌患者接受了经动脉灌注顺铂治疗，其中13例联合放疗，10例未联合放疗。顺铂加放疗组接受的动脉内顺铂总剂量为200 - 400mg，并同时接受总剂量为30Gy的放疗。顺铂组接受的动脉内顺铂总剂量为100 - 600mg。在顺铂加放疗组中，总体肿瘤反应率为92%。13例患者中有7例（53%）获得完全缓解（CR），2年精算生存率为92%。7例完全缓解者中只有1例出现局部复发。在顺铂组中，总体肿瘤反应率为90%。10例患者中有4例（40%）获得CR，中位生存期为8个月。4例完全缓解者中有3例出现局部复发。两组在副作用发生频率上无显著差异。与单纯动脉内顺铂治疗相比，动脉内顺铂联合放疗导致膀胱癌复发率非常低。这种方法对膀胱癌有效，可能会成为这类癌症的首选治疗方法。
