前輔助放射化學治療併尿道切除於侵襲性膀胱癌之應用：病例報告
方琬云 陳俊吉 王百孚
彰化基督教醫院 泌尿科
Invasive bladder cancer under neoadjuvant concurrent chemo-radiotherapy with palliative TUR-BT: A case report
Wan-Yun Fang, Chun-Chi Chen, Pai-Fu Wang
Division of Urology, Department of Surgery, Changhua Christian Hospital
Introduction:
Although radical cystectomy and/or pre-operative chemotherapy were standard management in invasive bladder cancer, some patients were still unable to accept the aggression and risks of the procedure. We tried to modify another treatment modality with negotiation base on patient’s request.
Case presentation:
A 57-year-old male, who has hypertension and type 2 diabetes mellitus, was present with painless gross hematuria and papillary urothelial carcinoma with high grade tumor was found on February, 2016. MRI showed cT3N0M0 tumor and radical cystectomy with neobladder reconstruction was suggested. However, the patient refused to do the surgery and decided to receive neoadjuvant concurrent chemo-radiotherapy (CCRT) and followed by palliative TUR-BT. After CCRT with 5600cGy/28fx to the lymphatic region, tumor boost to 6600cGy, and two cycles of cisplatin/5-FU chemotherapy were completed, 1st stage TUR-BT was arranged on May, 2016 and pathology showed no tumor invasion over muscularis propria. 2nd stage TUR-BT was performed for residual tumors on July, 2016. Gross hematuria was noted again on September, 2016, cystoscopy showed suspected recurrence, but pathology showed negative of malignancy.
Conclusion:
Fair tumor control was found eventually.