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首页> 外文期刊>Cardiovascular and Interventional Radiology: A Journal of Imaging in Diagnosis and Treatment >Comparing intra-arterial chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone: A randomised prospective pilot study for T1G3 bladder transitional cell carcinoma after bladder-preserving surgery
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Comparing intra-arterial chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone: A randomised prospective pilot study for T1G3 bladder transitional cell carcinoma after bladder-preserving surgery

机译:比较动脉内化疗与膀胱内化疗相结合单独的膀胱内化疗:膀胱保存手术后T1G3膀胱过渡细胞癌随机前瞻性试验研究

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摘要

Purpose: To compare the efficacy of intra-arterial chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone for T1G3 bladder transitional cell carcinoma (BTCC) followed by bladder-preserving surgery. Materials and Methods: Sixty patients with T1G3 BTCC were randomly divided into two groups. After bladder-preserving surgery, 29 patients (age 30-80 years, 24 male and 5 female) received intra-arterial chemotherapy in combination with intravesical chemotherapy (group A), whereas 31 patients (age 29-83 years, 26 male and 5 female) were treated with intravesical chemotherapy alone (group B). Twenty-nine patients were treated with intra-arterial epirubicin (50 mg/m2) + cisplatin (60 mg/m2) chemotherapy 2-3 weeks after bladder-preserving surgery once every 4-6 weeks. All of the patients received the same intravesical chemotherapy: An immediate prophylactic was administered in the first 6 h. After that, therapy was administered one time per week for 8 weeks and then one time per month for 8 months. The instillation drug was epirubicin (50 mg/m2) and lasted for 30-40 min each time. The end points were tumour recurrence (stage Ta, T1), tumour progression (to T2 or greater), and disease-specific survival. During median follow-up of 22 months, the overall survival rate, tumour-specific death rate, recurrence rate, progression rate, time to first recurrence, and adverse reactions were compared between groups. Results: The recurrence rates were 10.3 % (3 of 29) in group A and 45.2 % (14 of 31) in group B, and the progression rates were 0 % (0 of 29) in group A and 22.6 % (7 of 31) in group B. There was a significant difference between the two groups regarding recurrence (p = 0.004) and progression rates (p = 0.011). Median times to first recurrence in the two groups were 15 and 6.5 months, respectively. The overall survival rates were 96.6 and 87.1 %, and the tumour-specific death rates were 0 % (0 of 29) and 13.5 % (4 of 31) in groups A and B, respectively. During the intra-arterial chemotherapy cycle, although more than 50 % patients experienced some toxicities, most were minor and reversible [grade 1-2 (46.7 %) vs. grade 1-2 (6.9 %)]. Conclusion: These findings suggest that combining intra-arterial chemotherapy with intravesical chemotherapy could delay tumour recurrence and progression compared with intravesical chemotherapy alone and this type treatment is relatively safe.
机译:目的:比较动脉内化疗结合膀胱内化疗的疗效与单独的T1G3膀胱过渡细胞癌(BTCC)相结合,其次是膀胱保存手术。材料和方法:60例T1G3 BTCC患者随机分为两组。在膀胱保存手术后,29例患者(30-80岁,男性和5名女性)接受动脉内化疗与膀胱内化疗(A组)结合,而31例患者(29-83岁,26名男性和5岁女性单独用膀胱内化学治疗(B组)。每4-3周后2-3周用动脉内运动蛋白(50mg / m2)+顺铂(60mg / m 2)化疗治疗二十九个患者。所有患者都接受了相同的膀胱内化疗:在前6 H中施用即时预防型。之后,每周一次施用治疗8周,然后每月一次持续8个月。滴注药物是对比素(50mg / m 2),每次持续30-40分钟。终点是肿瘤复发(阶段Ta,T1),肿瘤进展(至T2或更大)和疾病特异性存活。在22个月的中位随访期间,在组之间比较了整体生存率,肿瘤特异性死亡率,复发率,进展率,以及群体之间的递增时间和不良反应。结果:A组A和B组45.2%(31%)的复发率为10.3%(32个),A组和22.6%(共31例)的进展率为0%(29%) )在B组中,两组关于复发(P = 0.004)和进展速率的显着差异(P = 0.011)。两组初期前期复发的中位数分别为15%和6.5个月。总存活率分别为96.6和87.1%,肿瘤特异性死亡率分别为A和B组分别为0%(0×29)和13.5%(31%)。在动脉内化疗周期内,虽然50%以上的患者经历了一些毒性,但大多数是轻微的和可逆[级别1-2(46.7%)与级别1-2(6.9%)]。结论:这些研究结果表明,与单独的膀胱型化疗相比,将动脉内化疗与膀胱内化疗相比延迟肿瘤复发和进展,并且这种类型的处理相对安全。

著录项

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  • 作者单位

    Department of Urology First Affiliated Hospital Sun Yat-Sen University Guangzhou 510080 China;

    Department of Urology First Affiliated Hospital Sun Yat-Sen University Guangzhou 510080 China;

    Department of Urology First Affiliated Hospital Sun Yat-Sen University Guangzhou 510080 China;

    Department of Urology First Affiliated Hospital Sun Yat-Sen University Guangzhou 510080 China;

    Department of Interventional Oncology First Affiliated Hospital Sun Yat-Sen University 58;

    Department of Interventional Oncology First Affiliated Hospital Sun Yat-Sen University 58;

    Department of Interventional Oncology First Affiliated Hospital Sun Yat-Sen University 58;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 放射医学;
  • 关键词

    Bladder tumour; Chemotherapy; Intra-arterial perfusion; T1G3;

    机译:膀胱肿瘤;化疗;动脉内灌注;T1G3;

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