早期吡柔比星膀胱内灌注预防膀胱癌术后复发

目的:探讨膀胱肿瘤电切术(TURBt)后早期应用吡柔比星灌注化疗预防肿瘤复发的疗效。方法:对112例病理证实的膀胱移行细胞癌患者,59例行早期灌注(Ⅰ组),53例行常规灌注(Ⅱ组)。Ⅰ组于术后6小时内将30mg吡柔比星溶于40ml蒸馏水膀胱内灌注,保留2小时后排出,术后7天开始规律膀胱灌注;Ⅱ组于术后7天开始吡柔比星规律膀胱灌注,比较两组患者膀胱肿瘤复发率。结果:随访7~54个月,平均35个月,Ⅰ组6例膀胱肿瘤复发,Ⅱ组13例复发,差异有统计学意义;不良反应包括尿路刺激征、肉眼血尿等,两组比较差异无统计学意义。结论:TURBt后早期开始吡柔比星膀胱灌注化疗,可以显著降低膀胱肿瘤复发率。

The effectiveness of early intravesical instillation of pirarubicin after TURBt for preventing recurrence of bladder cancer

Objective:To investigate the effectiveness of early intravesical instillation of pirarubicin after TURBt on preventing recurrence of bladder cancer.Methods:One hundred cases of pathological proven bladder cancer were randomized into two groups: 59 cases in the first group were managed by intravesical instillation of pirarubicin within 6 hours after TURBt, followed by regular intravesical instillation of pirarubicin 7 days after operation. The regular intravesical instillations of pirarubicin were managed to the patients of the second group (53cases) from 7days after operation. The recurrence rates and side effects between two groups were examined.Results:After 35 months (7~54months) fellow-up , the recurrence rate of first group was 10.2%, and that of control group was 24.5%. There is a markedly difference between two groups. The incidence of side effects between two groups was similar.Conclusions:Early intravesical instillation of pirarubicin after TURBt can significantly decrease the recurrence of bladder cancer.