Moonen L M, Horenblas S, van der Voet J C, Nuyten M J, Bartelink H
Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam.
Br J Urol. 1994 Sep;74(3):322-7. doi: 10.1111/j.1464-410x.1994.tb16620.x.
To retrospectively analyse the efficacy and toxicity of conservative treatment for T1G3 and T2-3a bladder carcinoma and to compare the results with those obtained in a previous study using caesium implantation.
Between 1987 and 1990 12 patients with high-grade T1 tumours and 28 with T2-3a tumours were treated using this combined approach. All tumours were solitary with a diameter not exceeding 5 cm. Treatment consisted of transurethral resection, a course of external irradiation (30 Gy in 15 fractions) to the whole pelvis and an implant procedure.
With a mean follow-up of 40 months (range 24-65) 31 patients remained free of disease and nine relapsed: three with distant metastases, two with bladder recurrence and four with combined bladder and distant relapse. Three patients showed tumour at the original site. The 5 years actuarial rate of local control was 84% with an overall 5 years actuarial survival of 86%. Early problems included bladder leakage, wound infection and psychological problems. Late complications in four patients, was transient ulceration at the implant side causing mild dysuria.
Implantation with iridium is equally effective as with caesium but has significantly fewer complications.
回顾性分析T1G3和T2 - 3a期膀胱癌保守治疗的疗效和毒性，并将结果与先前一项使用铯植入的研究结果进行比较。
1987年至1990年间，12例T1期高级别肿瘤患者和28例T2 - 3a期肿瘤患者采用这种联合方法进行治疗。所有肿瘤均为单发，直径不超过5 cm。治疗包括经尿道切除术、全盆腔外照射疗程（15次分割，共30 Gy）及植入手术。
平均随访40个月（范围24 - 65个月），31例患者无疾病复发，9例复发：3例有远处转移，2例膀胱复发，4例膀胱和远处联合复发。3例患者在原部位出现肿瘤。5年局部控制精算率为84%，5年总精算生存率为86%。早期问题包括膀胱漏、伤口感染和心理问题。4例患者出现晚期并发症，为植入侧短暂溃疡，导致轻度排尿困难。
铱植入与铯植入效果相同，但并发症明显较少。
