放射線治療膀胱癌

RADIOTHERAPY IN CARCINOMA OF URINARY BLADDER

丁瑞山(Ruey S. Ding) ； 鍾昌宏(Chang H. Chung) ； 陳光耀(Kuang Y. Chen)

《中華放射線醫學雜誌》 5卷2期 (1980/06) Pp. 151-160

摘要

自1982年1月至1974年12月，榮民總醫院癌病治療中心先後使用放射線治療77例膀胱癌患者。其年齡主要分佈於50至70歲間，平均年齡爲80歳。最主要的症狀是血尿，其中無痛性血尿占83%（84/77），疼痛性血尿占14%（11/77）。在組織病理學上，移形細胞癌占65%（50/77）。治療方治有單獨使用放射線治療、手術後放射線治療、手術前放射線治療及復發後放射線治療，5年絶對生存率依次爲24%（7/29）、39%（9/23）、50%（1/2）及40%（2/5），10年絶對生存率依次爲29%（5/17）、25%（2/8）、50%（1/2）及67%（2/3）。在89位接受完全治療的病人中，5年絶對生存率爲32%（19/59）、10年爲33%（10/30）。如果輸尿管或腎臟疑被侵犯或阻塞者，5年的絶對生存率爲27%（3/11）；如無侵犯或阻塞病徵，5年絶對生存率則爲38%（15/40）；放射線治療之併發症發生率爲3.9%（3/76）；死於非膀胱癌疾病者占4%（3/77）。在此77例中發現有轉移病灶，依次爲骨骼、鼠蹊淋巴結、生殖器官、肺和肝。俟後若能適當的改進放射線治療的方式或種類以及合併其他的治療方法並及早發現，或許能使膀胱癌有較佳之預後。

並列摘要

The clinical charts of 77 patients with carcinoma of urinary bladder were reviewed. They were treated in the Cancer Therapy Center, Veterans General Hospital, between 1962 and 1974. An age range of 50-70 years, with an average of 60, was noted. The most common symptom was hematuria, 83% (64/77) being painless hematuria and 14%(11/77) being painful hematuria. 65%(50/77) of the cases were transitional cell carcinoma. The absolute 5-year survival rates for radiotherapy alone, postoperative radiotherapy, preoperative radiotherapy and for recurrence were 24%(7/29), 39%(9/23), 50%(1/2) and 40%(2/5). The absolute 10-year survival rate were 29%(9/25), 25%(2/8), 50%(1/2) and 67%(2/3) respectively. The total 5-year, 10-year absolute survival were 32%(19/59) and 33%(10/30). If the ureter and kidney were suspected to have been involved or obstructed in X-ray finding, the absolute 5-year survival rate was 27%(3/11) versus 38%(15/40) in those without suspection. The radiation complication rate was 3.9%(4/76), 3%(3/77) of the patients died of intercurrent disease. The most common sites of metastases were bone, inguinal lymphnode, genital organ, lung and liver. If types or methods of radiotherapy were modified or combined with other treated modalities and early detection, the prognosis maybe improved.