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目的 分析T2、T3期膀胱移行细胞癌行部分膀胱切除术后放射治疗及膀胱内灌注治疗疗效。方法 回顾性分析本院 93例膀胱癌行部分膀胱切除术后放射 +化疗疗效 ,其中 5 8例接受放射治疗及灌注化疗 (放 +灌组 ) ,35例仅接受膀胱内灌注化疗 (灌注组 )。放射治疗采用 8或 18MVX射线 ,照射剂量为 5 0~ 6 0Gy。膀胱内灌注采用噻替哌或卡介苗 ,前者 5 0~ 6 0mg/次 ,2次 /周 ,共 6次 ;后者 0 .5mg/次 ,1次 /周 ,共 3次。结果 放 +灌组和灌注组 3年局部控制率分别为 6 8.6 %、48.2 %(χ2 =4.0 8,P =0 .0 44 ) ;1、3、5年生存率分别为 94.7%、70 .7%、49.5 %和 87.2 %、5 9.9%、35 .7% (χ2 =1.77,P =0 .184) ;放 +灌组生存 5年者有 78.6 %保存膀胱。放 +灌组放射反应大 ,但患者都能耐受。结论 T2、T3期膀胱移行细胞癌行部分膀胱切除术后放射治疗 +膀胱内灌注化疗可以降低局部复发。
Objective To analyze the curative effect of radiation therapy and intravesical instillation after partial cystectomy in T2 and T3 bladder transitional cell carcinoma. Methods A retrospective analysis of 93 cases of bladder cancer in our hospital after partial cystectomy radiotherapy and chemotherapy, of which 58 cases received radiation therapy and perfusion chemotherapy (put + irrigation group), 35 cases received only intravesical chemotherapy (perfusion group) . Radiation therapy using 8 or 18 MVX rays, irradiation dose of 50 ~ 600Gy. Intravesical infusion of thiotepa or BCG, the former 50 ~ 60mg / time, 2 times / week, a total of 6 times; the latter 0.5 mg / time, 1 time / week, a total of 3 times. Results The three-year local control rates of perfusion group and perfusion group were respectively 6 8.6% and 48.2% (χ2 = 4.08, P = 0.044). The 1-, 3-, and 5-year survival rates were 94.7% and 70%, respectively. 7%, 49.5%, 87.2%, 59.9%, 35.7% (χ2 = 1.77, P = 0.184). Radiation group put + irrigation group, but patients can tolerate. Conclusion T2 and T3 bladder transitional cell carcinoma underwent partial cystectomy after radiotherapy and intravesical chemotherapy can reduce the local recurrence.