吡柔比星与丝裂霉素膀胱灌注预防人膀胱癌复发比较的Meta分析

目的 用Meta分析比较吡柔比星（THP）、丝裂霉素C（MMC）膀胱灌注预防膀胱癌术后复发的疗效观察与毒性。方法 检索国内外已公开发表的关于THP与MMC膀胱灌注治疗人膀胱癌复发的比较性研究资料,对纳入研究的资料进行统计学综合（Meta分析）。结果共有8项研究符合标准被纳入,涉及总病例数629例,其中进行THP灌注治疗314例,MMC治疗315例;最大随访期内分别有10.5%（33/314）和34.6%（109/315）出现复发。Meta分析结果提示THP组预防肿瘤复发作用统计学上显著优于MMC组（OR0.34,95%CI0.22～0.54,P〈0.05）;6项研究报道了治疗毒性（主要是膀胱炎）的比较,Meta分析结果提示THP组膀胱炎发生率明显低于MMC组（OR0.49,95%CI0.29～0.82,P〈0.05）。结论 THP膀胱灌注预防人膀胱癌复发作用优于MMC,但其膀胱炎发生率较MMC低。

Comparison of intravesical pirarubicin with mitomycin C prevention recurrence of superficial bladder cancer: meta-analysis

Objective To compare the prophylactic efficacy and toxicity of intravesical pirarubicin(THP) with mitomycin C(MMC) on recurrence of Chinese bladder cancer using a Meta-analysis.Methods We retrieved published comparative studies on intravesical THP versus MMC for bladder cancer of Chinese people,and pooled the data from eligible studies (Meta-analysis).Results Eight trials including 629 patients were enrdled in the inclusion criteria.Of these patients 314 were treated with THP and 315 with MMC.Within the maximum follow-up,10.5%(166/708)of the patients treated with THP and 34.6%(109/315)of those with MMC had recurrence of bladder tumor.Pooling data of a meta-analysis indicated that THP was statistically significantly superior to MMC in the prophylaxis of tumor recurrence (OR 0.34,95% CI 0.22-0.54,P<0.05).Six studies reported comparative data on toxicity mainly cystitis,combined result of these studies showed that the incidence of cystitis were significantly lower in THP group than MMC group (OR 0.49,95% CI 0.29-0.82,P<0.05).Conclusions The results of this meta-analysis suggest the significant superiority of intravesical THP therapy compared with MMC for the prevention of tumor recurrence,and the toxicity of THP therapy,especially the incidence of cystitis,is significantly lower than that of MMC therapy.