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目的 探讨放射治疗 +化疗预防肌层侵犯的浸润性膀胱癌保存膀胱术后复发的疗效。方法 2 3例肌层侵犯的浸润性膀胱移性细胞癌保存膀胱术后在丝裂霉素规则膀胱灌注化疗的基础上行放射治疗 (研究组 ) ,照射平均剂量为 51 4 8± 462cGy。以 2 9例同期同样病变行保存膀胱术后单纯丝裂霉素规则膀胱灌注化疗的为对照 (对照组 )。所有病例随访 3年以上 ,平均随访 41 6个月 ( 3 6-60 )。结果 研究组和对照组 3年盆腔复发率为 1 7 4%和 44 8% (P =0 0 3 6) ;3年远地转移率分别为 1 7 4和 2 4 1 %(P =0 554 ) ;3年生存率分别为 81 8%和 86 2 % (P =0 670 )。研究组除 2例因放射性膀胱炎分别中断 3d和 1周后继续治疗外 ,其余均按计划完成治疗。结论 保存膀胱术后放射 +化疗治疗能有效降低肌层肌层侵犯浸润性膀胱癌盆腔复发率 ,且是膀胱癌保膀胱术后理想的辅助治疗。
Objective To investigate the curative effect of radiotherapy + chemotherapy in preventing recurrence of invasive bladder cancer after invasive bladder cancer. Methods Twenty-three patients with invasive bladder transitional cell carcinoma invading the muscular layer were treated with radiation therapy (study group) on the basis of mitomycin regular bladder infusion chemotherapy after laparoscopic operation. The mean dose of irradiation was 51 48 ± 462 cGy. 29 cases of the same period of the same line of preservation of bladder surgery after mitomycin simple rule of bladder chemotherapy as a control (control group). All patients were followed up for more than 3 years, with an average follow-up of 41 6 months (range 3 to 60). Results The 3-year pelvic recurrence rates of the study group and the control group were 174% and 448%, respectively (P = 0 0 3 6). The 3 years distant metastasis rates were 174 and 214%, respectively (P = 0 554 ). The 3-year survival rates were 81 8% and 86 2%, respectively (P = 0 670). In addition to two cases of the study group due to radiation cystitis were interrupted 3d and 1 week after treatment, the rest were completed according to plan treatment. Conclusions Radiotherapy and chemotherapy after bladder cancer preservation can effectively reduce the recurrence rate of invasive muscular invasion of invasive bladder cancer, and is an ideal adjuvant therapy for bladder cancer after bladder preservation.