不同浓度吡柔比星膀胱灌注对表浅性膀胱癌患者术后复发及生活质量的影响

目的：比较不同浓度吡柔比星膀胱灌注对表浅性膀胱癌患者的生活质量以及复发的影响。方法回顾性分析该院2010年12月至2012年12月行表浅性肿瘤电切（TUR-BT）治疗的56例表浅性膀胱癌患者的临床资料，根据膀胱灌注药物浓度不同分为高浓度组25例，低浓度组31例。膀胱灌注吡柔比星灌注剂量30 mg，高浓度组为1.0 g/L，低浓度组为0.6 g/L。术后每周灌注1次，8周后，每月1次，至术后1年。随访比较两组患者的复发情况以及生活质量。患者生活质量评分采用欧洲癌症治疗研究组织（EORCT）的癌症患者生存质量核心量表（QLQ-QC30）以及表浅性膀胱癌患者特异性量表（QLQ-BLS24）进行问卷调查。结果所有患者均获得满意随访，时间为6-30个月，平均随访（17．6±1.2）个月。其中高浓度组随访期内1例复发，复发率为4.0%（1/25），复发时间为术后（12.4±0.8）个月；低浓度组随访期内3例复发，复发率为9.7％（3/31），平均复发时间为（9.8±0.6）个月。两组复发率以及平均复发时间比较，差异均有统计学意义（P〈0．05），两组患者的生活质量评分比较，差异无统计学意义（P〉0．05）。结论高浓度吡柔比星膀胱灌注能有效降低患者的复发率，延长复发时间，且对患者的日常生活无显著影响。

Influence of different concentration of pirarubicin intravesical instillation on the postoperative recurrence and quality of life of the patients with superficial bladder cancer

Objective To compare the effects of different concentrations of pirarubicin intravesical instillation on the re currence and quality of life（QOL） of patients with superficial bladder cancer. Methods Retrospective analysis was conducted on the clinical data 56 patients with superficial bladder cancer ,who underwent transurethral resection of bladder tumor （TURBT） in the hospital from December 2010 to December 2012. The patients were divided into two groups according to the concentrations of pirarubicin intravesical insticlation：high concentration group（H group,n=25） and low concentration group（L group,n=31）. Each infusion dose of pirarubicin was 30 mg ,and the H group was administrated with 1.0 g/L ,while the L group was administrated with 0.6 g/L. Both groups were perfused once a week after operation and once a month from 8 weeks to 1 year after operation. All cases were followed up,the recurrence rate and QOL of the both groups were compared. The QOL scores were assessed by EORCT QLQ-QC30 and QLQ-BLS24 questionnaire. Results All cases obtained satisfactory follow-up of 6-30 months,with an average of （17.6±1.2）months. 1 case recurred in H group during follow-up with the recurrence rate of 4.0%（1/25）,and the recurrence time was （12.4±0.8）months after operation;3 cases recurred in L group during follow-up with the recurrence rate of 9.7%（3/31） and the mean recurrence time of （9.8±0.6）months. The comparison of recurrence rate and mean recurrence time between the two groups had statistically significant difference（P〈0.05）,but there was no significant difference on the QOL score between the two groups （P〉0.05）. Conclusion High concentration of intravesical instillation of pirarubicin can effectively reduce the recurrence rate , prolong the time to recurrence,moreover it has no influence on the daily life of the patients.