卡介苗联合丝裂霉素灌注预防浅表性膀胱癌复发的疗效观察

目的观察卡介苗(BCG)联合丝裂霉素(MMC)灌注预防浅表性膀胱癌术后复发的临床疗效。方法 79例浅表性膀胱癌术后患者随机分为两组:A组为联合诱导组(40例),术后6 h内及术后1周、2周分别行膀胱腔内灌注MMC,术后3周开始BCG诱导加维持膀胱腔内灌注治疗(BCG"6+3"疗法)。B组为单纯BCG组(39例),术后3周开始接受BCG"6+3"疗法。定期行膀胱镜和尿脱落细胞学检查,观察两组患者的肿瘤复发和毒副作用情况。结果 A组肿瘤复发率为12.5%,B组肿瘤复发率为25.6%,A组复发率明显低于B组(P<0.05);两组毒副反应发生率差异无显著性意义(P>0.05)。结论浅表性膀胱癌术后早期采用卡介苗联合丝裂霉素灌注预防复发疗效较好,未增加毒副作用发生率,值得临床推广应用。

Clinical observation on Bacillus Calmette - Guerin combined with mitomycin C in prevention of post - operative recurrence of superficial transitional cell carcinoma in bladder

Objective To observe the prophylactic effect of Bacillus Calmette-Guerin（BCG） combined with mitomycin C（MMC） for prevention of post-operative recurrence of superficial transitional cell carcinoma in bladder.Methods Seventy-nine patients with superficial bladder cancers after operation were randomly divided into two groups.Forty patients in group A were immediately managed with intravesical instillation of MMC at 6 h after operation and at first and second weeks,followed by BCG ＂ 6 plus 3＂ regimen.Thirty nine patients in group B were treated with BCG ＂ 6 plus 3＂ regimen alone.Cystoscopy and urine cytological examination were performed in time.The side effects during the therapeutic course were observed.Results The recurrence rates of patients in group A and group B were 15.3%（9 /59） and 33.3%（17 /51）,respectively.The difference in recurrence rate between these 2 groups was significant（P 0.05）.The side effects in these two groups showed no significant difference（P 0.05）.Conclusion Intravesical instillation of Bacillus Calmette-Guerin（BCG） and mitomycin C（MMC） for early prevention of post-operative recurrence of superficial transitional cell carcinoma of bladder has good clinical effect.Furthermore,this therapy has few significant side effects,it is worthy for clinical application.