Analysis of intravesical mitomycin C combined with hyperthermia to treat T1G3 bladder urothelial carcinoma
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摘要: 目的:探讨丝裂霉素膀胱灌注热化疗治疗T1G3膀胱尿路上皮癌的疗效及安全性。方法:76例原发性或复发性T1G3膀胱尿路上皮癌患者,均行经尿道膀胱肿瘤电切术,40例患者术后接受单独丝裂霉素进行膀胱灌注治疗,36例患者接受术后予丝裂霉素进行膀胱灌注热化疗。随访时间>24个月。分析两种治疗方法的无复发生存期和无进展生存期。结果:在76例患者中,单纯膀胱灌注化疗组肿瘤复发率及进展率分别为35%及22.5%,膀胱灌注热化疗组复发率及进展率分别为13.9%和5.6%。两组比较差异有统计学意义。(P=0.034及P=0.036)。Kaplan-Meier分析显示两种治疗方法无复发生存率及无进展生存率差异有统计学意义(P=0.027及P=0.047)。结论:T1G3膀胱尿路上皮癌TURBT术后予MMC膀胱灌注热化疗治疗是安全,有效的。能有效降低T1G3膀胱尿路上皮癌术后复发和肿瘤进展风险。Abstract: Objective: To investigate the efficacy and safety of intravesical mitomycin C(MMC) combined with hyperthermia for patients with T1G3 bladder urothelial carcinoma after transurethral resection of the bladder tumor(TURBT). Method: Seventy-six patients suffering from primary or recurrent T1G3 transitional cell carcinoma of the bladder underwent TURBT. Forty patients received intravesical chemotherapy alone, whereas 36 patients underwent chemotherapy of MMC combined with hyperthermia. Minimum follow-up period was 24 months. Recurrence-free survival and progression-free survival of the two chemotherapy strategies following TURBT were analyzed. Result: Of the 76 patients completed the study were analyzed statistically valid. The tumor recurrence rate was 35% for patients who received intravesical chemotherapy alone after TURBT, compared with 13.9% for patients who received intravesical chemotherapy of MMC combined with hyperthermia after TURBT. The progression rate was 22.5% for patients who underwent intravesical chemotherapy alone and 5.6% for patients who underwent the combined hyperthermia. Kaplan-Meier curves showed significant difference in recurrence-free survival and progression-free survival between the two treatment strategies, with a log-rank P-value of 0.027 and 0.047, respectively.Conclusion: It can be a safe and effective treatment option after TURBT in patients with T1G3 bladder urothelial carcinoma for intravesical chemotherapy of MMC combined with hyperthermia. It is a good method to prevent the recurrence and reduce the risk of disease progression.
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Key words:
- bladder cancer /
- intravesical chemotherapy /
- hyperthermia /
- recurrence /
- progression
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