Objective: To explore the effect of radical TURBT combing with concomitant chemo-radiotherapy for muscle-invasive bladder cancer (MIBC). Methods: From 2010 to 2015, 73 patients were diagnosed as MIBC, in which 28 patients (TMT Group) received tri-modality bladder sparing treatment, including 21 males and 7 females, mean age (68.9±8.9) yr. There were 16 cases of T(2), 12 cases of T(3). 45 patients (RC Group) received radical cystectomy (RC), including 32 males and 13 females, mean age (66.3±9.6) yr. There were 25 cases of T(2), 18 cases of T(3) and 2 cases of T(4a). The effect of two treatment modality and influence for patient's life quality were retrospective analysis. Results: The overall survival (OS) rate of TMT group was 64.3%, cancer specific survival (CSS) rate was 78.6%. And the OS rate of RC group was 66.7%, CSS rate was 82.2%. There was no statistical difference between two groups. The life quality of TMT group was better than that of RC group. Conclusion: In strict control of indication criterion, rigorous postoperative follow-up and timely salvage radical cystectomy, tri-modality therapy can be used as a new option of muscle-invasive bladder cancer.
目的： 观察根治性经尿道膀胱肿瘤切除术联合术后放化疗的"三联"模式在肌层浸润性膀胱癌(MIBC)保留膀胱治疗上的效果。 方法： 回顾性分析2010年5月至2015年5月中日友好医院等3个中心收治的73例肌层浸润性膀胱癌患者资料。28例患者(TMT组)接受了根治性TURB＋术后联合放化疗。其中男21例，女7例，年龄(68.9±8.9)岁。T(2)期16例，T(3)期12例。同期45例患者(RC组)接受了根治性膀胱切除＋尿流改道术，其中男32例，女13例，年龄(66.3±9.6)岁。T(2)期25例，T(3)期18例，T(4a)期2例。分析两种治疗模式对于MIBC预后及生活质量的影响。 结果： TMT组的总体生存率为64.3%，肿瘤特异性生存率为78.6%。RC的总体生存率为66.7%，肿瘤特异性生存率为82.2%。总体生存时间分别为(47.9±3.2)个月和(48.5±2.6)个月。两组数据比较差异均无统计学意义(均P>0.05)。术后生活质量评分方面，TMT组优于RC组。 结论： 在严格控制适应证，进行严密的术后随访，并及时进行挽救性膀胱切除术的前提下，"三联"保膀胱疗法可以作为根治性膀胱切除术之外的MIBC患者的一种选择。.
Keywords: Bladder-sparing; Chemoradiotherapy; MIBC.