Vallancien G, Harouni M, Guillonneau B, Veillon B, Bougaran J
Department of Urology and Pathology, Institut Mutualiste Montsouris, Paris, France.
Urology. 1996 Feb;47(2):204-7. doi: 10.1016/S0090-4295(99)80417-8.
We report the first experimental studies of focused extracorporeal pyrotherapy.
Focused extracorporeal pyrotherapy has been used to treat superficial bladder tumors in a Phase II protocol in 25 patients. In 5 cases, for technical reasons, pyrotherapy was not used. In 20 patients (10 under general anesthesia and 10 under spinal anesthesia), the mean treated volume was 3 cm3 with an average of 300 shots and a mean skin focused length of 90 mm. Treatment time was 44 minutes; hospital stay was 2 days. Postoperatively, two skin burns and one acute retention were observed.
Of 20 patients, 15 (75%) had a normal urinary cytology bladder ultrasonography and cystoscopy at 1 month. In 67% of patients with primary tumor, there was no recurrence at 1 year; 33% had recurrent tumors. No infiltrative tumor or metastases have been observed during this follow-up (3 to 21 months).
These encouraging results show that ablation of superficial bladder tumor is feasible. The technique must be improved to allow treatment of larger tumor volume in a shorter time.
我们报告聚焦体外热疗的首批实验研究。
在一项II期方案中，聚焦体外热疗已用于治疗25例浅表性膀胱肿瘤患者。5例因技术原因未使用热疗。在20例患者中（10例全身麻醉，10例脊髓麻醉），平均治疗体积为3立方厘米，平均发射300次，平均皮肤聚焦长度为90毫米。治疗时间为44分钟；住院时间为2天。术后观察到2例皮肤烧伤和1例急性尿潴留。
20例患者中，15例（75%）在1个月时尿细胞学、膀胱超声和膀胱镜检查结果正常。原发性肿瘤患者中，67%在1年时无复发；33%有复发性肿瘤。在此次随访（3至21个月）期间未观察到浸润性肿瘤或转移。
这些令人鼓舞的结果表明，浅表性膀胱肿瘤的消融是可行的。必须改进该技术，以便在更短时间内治疗更大体积的肿瘤。
