经导管动脉化疗栓塞治疗在晚期膀胱癌合并出血中的作用

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摘要目的探讨经导管动脉化疗栓塞术（TACE）在控制晚期膀胱癌的膀胱出血以及控制肿瘤生长中的作用。方法选择2015年1月～2016年12月海军总医院收治的43例晚期膀胱癌并肉眼血尿患者，采用经导管膀胱动脉灌注化疗并用栓塞微球栓塞供血动脉，30 d后再重复治疗1次，观察膀胱出血止血成功率、肿瘤病灶缩小情况以及肿瘤降期的情况。结果第1次TACE后所有患者膀胱出血均得到控制，止血成功率为100%。第2次治疗后30 d，MRI提示肿瘤体积缩小大于50%者27例（62.8%），12例（28.0%）患者获得降期，肿瘤分期与术前比较差异有统计学意义（P < 0.05）。未见严重副作用和并发症。结论 TACE可以有效控制晚期膀胱癌的膀胱出血，并对肿瘤生长有明显抑制的作用。

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	卢伟杨超马军朋杜鹏蒋富强杨剑解鹏张哲

关键词 ：膀胱癌, 膀胱出血, 经导管动脉化疗栓塞术, 肿瘤分期

Abstract：Objective To investigate effects of transcatheter arterial chemoembolization (TACE) in the treatment of controlling the bladder bleeding and inhibiting the tumor growth in advanced bladder cancer. Methods From January 2015 to December 2016, in Navy General Hospital, 43 patients with advanced bladder cancer and gross hematuria were selected, they were treated with bladder arteries chemoembolization (TACE). All the patients presented macroscopic haematuria. The catheters were inserted into bladder supplying arteriesand anticancer drugs infusion and followed by embolization with microsphere. Procedures were repeated 30 d after the first treatment. The success rate of hemostasis, shrinkage of tumor and downstage of tumors after TACE was observed. Results Bladder bleeding stopped after the first TACE in all patients. Bladder tumor shrinkageof more than 50% in 27 patients (62.8%) was found by MRI 30 d after the second treatment. Down stage of tumors were found in 12 patients (28.0%). The differences of tumor stage between pre and post treatment were statistical significant (P < 0.05). No serious side effects and complications were developed in all patients. Conclusion TACE is effective in controlling bladder bleeding in advanced bladder cancer. The tumor growth is significantly inhibited by the procedures.

Key words： Bladder cancer Bladder bleeding Transcatheter arterial chemoembolization Tumor staging

基金资助:国家自然科学基金资助项目（30670612）；
北京市科技计划课题（Z151100003915112）；
中华国际医学交流基金会先声抗肿瘤治疗专项科研基金（Z-2014-06-15322）；
海军总医院人才引进基金（RCYJZX－009）。

引用本文:

卢伟杨超马军朋杜鹏蒋富强杨剑解鹏张哲. 经导管动脉化疗栓塞治疗在晚期膀胱癌合并出血中的作用[J]. 中国医药导报, 2017, 14(26): 83-85,93.
LU Wei YANG Chao MA Junpeng DU Peng JIANG Fuqiang YANG Jian XIE Peng ZHANG Zhe. Transcatheter arterial chemoembolization in the treatment of advanced bladder cancer with hemorrhage. 中国医药导报, 2017, 14(26): 83-85,93.

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[1] 孙艳.临床肿瘤学高级教程[M].北京：人民军医出版社，2011：712-727.
[2] Hall MC，Chang SS，Dalbagni G，et al. Guideline for the management of nonmuscle invasive bladder cancer（stages Ta，T1，and Tis）：2007 update [J]. J Urol，2007，178（6）：2314-2330.
[3] Brausi M. Approaches to the management of non-muscle invasive bladder cancer： a review of current guidelines and best practice recommendations from the International Bladder Cancer Group [J]. Eur Urol Suppl，2008，7（10）：615-617.
[4] Muraro GB，Grifoni R，Spazzafumo L. Endoscopic therapy of superficial bladder cancer in high-risk patients：Holmium laser versus transurethral resection [J]. Surg Technol Int ，2005，14 （14）：222-226.
[5] 曾福华，杨土保，江勃年，等.原发浅表性膀胱癌预后影响因素分析[J].中华泌尿外科杂志，2004，25（10）：669-672.
[6] Halpenny D，Salati U，Torregiani WC，et al. Selective arterial embolization for control of haematuria secondary to advanced or recurrent transitional cell carcinoma of the bladder [J]. JBR-BTR，2013，96（5）：282-285.
[7] Bujons A，Caffaratti J，Garat JM，et al. Long-term follow-up of transitional cell carcinoma of the bladder in childhood [J]. J Pediatr Urol，2014，10（1）：167-170.
[8] Góes Junior AMDO，Jeha SAH，Queiroz MVB，et al. Selective vesical artery embolization for treatment of gross hematuria due to actinic cystitis [J]. J Vasc Bras，2015，14（4）：341-345.
[9] Azuma H，Inamoto T，Ibuki N，et al. Novel bladder preservation therapy for locally invasive bladder cancer：combined therapy using balloon-occluded arterial infusion of anticancer agent and hemodialysis with concurrent radiation [J]. Int J Oncol，2010，37（4）：773-785.
[10] Kanuma R，Ishikawa H，Takaoka E I，et al. Bladder preservation therapy using proton boost concurrently combined with intra-arterial chemotherapy for invasive bladder cancer [J]. Int J Radiol Oncol Bio Physics，2015，93（3）：E210-E210.
[11] Abt D，Bywater M，Engeler DS，et al. Therapeutic options for intractable hematuria in advanced bladder cancer [J]. Int J Urol，2013，20（7）：651-660.
[12] McIvor J，Williams G，Southcott RD. Control of severe vesicalhaemorrhage by therapeutic embolization [J]. Clin Radiol，1982，33（5）：561-567.
[13] 王玉林，胡荣奎，贾中芝，等.动脉内栓塞治疗晚期膀胱癌22例临床总结[J].介入放射学杂志，2015，24（4）：311-313.
[14] 孙昊，李晓光，金征宇，等.经导管双侧髂内动脉灌注化疗治疗浸润性膀胱癌[J].介入放射学杂志，2010，19（6）：454-457.
[15] 汤钊猷.现代肿瘤学[M]上海：复旦大学出版社，2011：1486-1487.
[16] Pisco JM，Martin JM，Correia GM. Internal iliac artery： Embolisation to control haemorrhage from pelvic neoplasms [J]. Radiol，1989，172（2）：337-339.
[17] El-Assmy A，Mohsen T. Internal iliac artery embolization for the control of severe bladder hemorrhage secondary to carcinoma：long-term follow-up [J]. Scient W J，2007，7（1）：1567-1574.
[18] Nabi G，Sheikh N，Greene D，et al. Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies： preliminary experience and long-term follow-up [J]. BJU Internat，2003，92（3）：245-247.
[19] 张遂兵，潘卫兵，朱斌.输尿管管路封堵器在钬激光碎石治疗输尿管结石中的效果分析[J].中国当代医药，2016， 23（22）：67-69.
[20] García JN，García TG，Selva RM，et al. Uterine artery embolisation as management of postoperative gynaecological haemorrhage [J]. Arch Med Sci，2015，11（4）：899-900.
[21] 张国辉，王占国，李志辉，等.肌层浸润性膀胱癌保留膀胱综合治疗的疗效评价研究[J].癌症进展，2016，14（2）：102-105.