Résumé
Objective To compare the result of T2/T3 transitional cell carcinoma (TCC) of the urinary bladder after segmental cystectomy, treated by postoperative radiation plus intravesical chemotherapy and postoperative intravesical chemotherapy alone.Methods From 1985 to Dec.1995 patients with T2/T3 TCC bladder cancer who had been treated by segmental cystectomy were eligible for this retrospective analysis. Fifty-eight patients received postoperative radiotherapy plus intravesical chemotherapy (RT+IVC) and 35 patients were given postoperative intravesical chemotherapy (IVC) with thio-TEPA or calmette-Gue'rin bacilli (BCG). For radiation,8 or 18 ?MV X-ray was given with total dose of 50-60 ?Gy. Vesicoclysis was performed on 50-60 mg thio-TEPA twice per week and 0.5 mg BCG per week.Results The 3-year local control rates of RT+IVC and IVC groups were 68.6% and 48.2% showing a difference statistically significant (? 2=4.08,P=0.044).The 3- and 5-year survival rates of RT+IVC and IVC groups were 70.7%,49.5% and 59.9%,35.7% ,showing no significant difference (? 2=1.77,P=0.184). Among the 5 year survivors of the RT+IVC patients, 78.6% had their bladder preserved. Though untoward radiation reactions were severer, they were tolerated well.Conclusions Combined radiation therapy plus intravesical chemotherapy is indicated for T2/T3 bladder cancer after segmental cystectomy. Multimodality therapy is more favored to improve both the local control and the possibility of preserving the bladder.
Résumé
Objective To evaluate the effect of radiotherapy(RT)combined with arterial infusion chemotherapy(AIC) in the treatment of locally advanced or recurrent rectal cancer. Methods From May.1994 to Dec.2000, 62 patients with locally advanced or recurrent rectal cancer were randomized into two groups: RT alone group(31 patients)and the combined group(RT+AIC, 31 patients). All patients were treated with conventional radiotherapy by 8 18 ?MV X ray to a total dose of D T40 50 ?Gy in 4 to 5 weeks for the resectable disease, or to a dose of 60 70 ?Gy in 6 to 7 weeks for the unresectable disease. However, the combined group received concurrent arterial infusion chemotherapy by DDP 70?mg/m 2 and 5 FU 600 ?mg/m 2 in 2 3 cycles. Results The response rates were 83.9% and 54.8% in combined group and RT alone group, respectively (P