经尿道膀胱肿瘤电切术中羟基喜树碱单次大剂量灌注与术后多次常规剂量灌注化疗预防膀胱癌复发的比较

目的：比较TURBT术中羟基喜树碱单次大剂量灌注与术后多次常规剂量灌注化疗预防膀胱癌复发的疗效与不良反应.方法：浅表性膀胱癌101例均行TURBT术.随机分为两组,第1组（49例）,手术结束时立即单次膀胱灌注羟基喜树碱30 mg;第2组（52例）,术后1周开始灌注,剂量20 mg,第周1次,8次后改为每月1次,至术后24个月.比较它们的疗效与不良反应.结果：随访36个月,第1组和第2组总复发率分别为18.4%和15.4%,两组间比较差异无统计学意义（P=0.67）;第1组和第2组总不良反应率分别为12.2%和30.8%,两组间比较差异有统计学意义（P=0.02）.结论：羟基喜树碱术中单次大剂量灌注预防浅表性膀胱癌术后复发疗效与术后多次常规剂量灌注化疗效果相当,而不良反应发生率低,费用少.

TURBT Along with Single-dose Instillation of HCPT in the Treatment of Superficial Bladder Transitional Caner

Objective：To compare the efficacy and side effects of single intravesical perfusion of H ydroxycamp- totheeine （HCPT） and multiple instillation of HCPT for prophylaxis of primary superficial bladder cancer recurrence. Methods：A total of 101 patients with superficial bladder carcinoma who underwent Transurethral resections of bladder tumors were randomized into 2 groups. Group 1（n=49） ： intravesical perfusion of 30 mg HCPT was given immediately after operation. Group 2 （n= 52） ： intravesical perfusion of HCPT was given 20mg/time/week, which was started from 1 week after operation and lasted for 8 weeks. After that, intravesical perfusion of HCPT was performed every month till 2 years. Results：Patients were followed up for 3 years. In group 1, The incidence rate was 18.40/00 （9/49）. In group 2, recurrence rate was 15.4~%（8/52）. There was no significant difference be tween the two treatments （P=0.67）. However, Side effects of group 1 （12.2%） were significantly lower than that of group 2 （30.8 % ） （P=0.02）. Conclusions ： Single intravesical perfusion of HCPT immediately after operation has comparable effect as multiple perfusion of HCPT for prophylaxis of primary superficial bladder cancer recurrence, but with advantages of being low cost and less side effects.