【文档说明】表浅性膀胱肿瘤卡介苗BCG膀胱灌注治疗方案及其与化疗效果的比较课件.ppt，共(21)页，478.000 KB，由小橙橙上传

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一、表浅性膀胱肿瘤简述TNN分期:原发肿瘤(T)分期:Tx:无法对原发肿瘤作出估计。T0:无原发性肿瘤的证据。Tis:原位癌。Ta:非浸润性乳头状癌。T1:肿瘤侵犯上皮下结缔组织。T2;肿瘤侵犯浅表肌肉(内半)。T3a:肿瘤侵犯深部肌肉(外半)。T3b:肿瘤侵犯膀胱脂肪。T4:肿瘤已侵犯下列之一

:前列腺、子宫、阴道、盆壁、腹壁。区域淋巴结(N)分期:Nx:淋巴结有无转移不肯定。N0:淋巴结无转移。N1:单个淋巴结转移,最大直径≤2cm。N2:单个淋巴结转移,最大直径＞2cm、≤5cm。或多个淋巴结转移,最大直径均≤5

cm。N3:淋巴结转移,最大直径＞5cm。远处转移(M)分期:Mx:转移范围不肯定。M0:无远处转移。M1:有远处转移。定义:指病灶未侵及膀胱肌层,包括:Ta,CIS,T1。60%~70%临床表现:无痛性血尿,膀胱刺激症治疗原则:手术(TUR)为主,化疗、免疫治疗、生

物治疗为辅BCG+TURvsTURonly◼freeofrecurrenceforameanfollow-upof33months:BCG+TUR:68%TURonly:41%--fromSWOG(SouthwestOncologyGroup)二、BCG膀胱灌注BCGIntravesi

caltherapyⅠ.goalsⅡ.sideeffectsⅢ.dosageandadministrationⅣ.treatmentschedulegoals:◼eradicatingexistingdisease,◼treatcarcinomainsitu◼reducingdiseasere

currenceandprogression,◼improvingpatientsurvival.Sideeffects:◼Cystitis◼dysuria◼hematuria◼BCGinfection◼fever/chillsdosageandadmi

nistration:◼1x108~1x1010CFU(colony-formingunits)◼120mgBCG+50mlNS◼urethralcatheter,convertingbodyposition/15m

insfor2hs◼follow-up:every3monthsat1styear,6months→1yearTreatmentschedule:◼asingleschedule◼maintenancetherapy(

6+3)◼doublescheduleothers“6+3”Regimen:1.inductionperiod:weeklyfor6weeks2.maintenanceperiod:3weeklyat3,6,12,18,24,

30,and36months6+3vs6+6:regimenitem6+36+6CR*CIS87%63%tumor-free83%43%~67%Others:1.w*6→2w*6→mfor2~3ys2.CISorh

igh-grade:(6+3)→3-weekatyears4,5,6,8,10,and12三、与化疗效果比较常用化疗药物◼噻替哌◼丝裂霉素C◼阿霉素◼表阿霉素Comparison:◼instillatingtime◼effect◼mechanism◼increasingdose◼ma

intenancetherapyCombinationtherapy:◼Megadosevitamins◼IL-2◼Interferon◼intravesicalchemotherapeuticdrugs

:MMCet.◼BCG-CWS(卡介苗细胞壁骨架)Thankyou