丝裂霉素C加卡介苗灌注预防浅表性膀胱癌术后复发疗效观察

目的观察丝裂霉素C加卡介苗灌注预防浅表性膀胱癌术后复发的疗效。方法将 83例行经尿道膀胱镜下肿瘤电切术 (TUR)的浅表性膀胱癌患者随机分为丝裂霉素C加卡介苗 (BCG)组 (5 0例 )和单纯丝裂霉素 (MMC)组 (3 3例 ) ,前者术后即刻采用MMC灌注加小剂量BCG维持 ,后者单用传统MMC灌注。观察两组患者的肿瘤复发和毒副反应情况。结果经 12— 66个月 ,平均 3 2个月随访 ,BCG组 3例患者肿瘤复发 ,MMC组 7例患者肿瘤复发 ,两组复发率间的差异有显著性意义 (P <0 .0 5 ) ;BCG组患者毒副反应发生率为 10 % ,MMC组为 66.7%。结论TUR术后即刻膀胱灌注MMC加小剂量BCG维持预防浅表性膀胱癌术后复发疗效较好 ,不良反应少 ,临床使用安全可靠。

Effect of mitomycin C instilled immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer

Objective To observe therapeutic effects of intravesical instillation of mitomycin C (MMC) immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer. Methods 83 patients with superficial bladder cancer were randomly divided into two groups, 50 cases were managed with intravesical instillation of mitomycin C immediately after TUR added with low dose BCG maintenance therapy (group A), 33 cases were treated with traditional method of MMC therapy (group B) to prevent recurrence of superficial bladder cancer. Results After 12-66 months (mean 32 months) following up, 3 patients had tumor recurrence in the group A and 7 patients in the group B, the rate of tumor recurrence of the group A was 6 0% (3/50) and that of the group B was 21.2%(7/33), and there was a significantly difference between two groups ( P<0.05). Side effects of the group B were obviously more than that of the group A. Conclusion Intravesical instillation of MMC immediately after TUR added with low dose BCG maintenance therapy is effective to prevent patients with superficial bladder cancer from recurrence.