单次腔内灌注表柔比星预防浅表性膀胱癌术后复发

目的探讨临床应用柔比星单次腔内灌注预防浅表性膀胱癌术后复发的可行性。方法 了解表柔比星单次与多次灌汪预防表性膀胱癌术后复发的长期疗效,并与丝裂霉素疗效比较。将47例浅表性膀胱癌（Ta-1,G1－2）入选患者随机分为3组,A组（16例）患者术后6h内单次灌注表柔比星80mg;B组（15例）术后定期灌注柔比星40mg,至术后1年;C组（16例）用药为丝裂霉素,剂量及用法同B组。对入选病例行前瞻性、随机对照临床研究,随访患者无瘤生存间期、肿瘤复发率及不良反应发生情况。对所有患者术后密切随访满3年。结果 发现3年患者术后3年无病间期差异无显著性意义（F＝3．25,P＞0．05）。3组膀胱癌病例中术后1年复发情况分别为：A组1例（6．25％）、B组2例（13．3％）、C组2例（12．5％）,其差异无显著意义（χ^2＝0．496,P＞0．05）。3年复发情况分别为：A组5例（33．3％）,B组和C组各4例（26．7％,25．0％）,其差异亦无显著意义（χ^2＝0．290,P＞0．05）。不良反应发生情况分别为：A组2例（13．3％）、B组7例（（46．7％）、C组7例（43．8％）,A组患者不良反应发生率显著低于B、C2组（χ^2＝14．56,P＜0．01）。结论 表柔比星腔内灌注预防浅表性膀胱癌术后远期复发的作用可靠,可作为浅表性膀胱术后患者有效的临床辅助治疗措施。

Single instillation of epirubicin for the prophylaxis of recurrent primary superficial bladder carcinoma

OBJECTIVE: To determine the feasibility of single dose intravesical epirubicin in the prevention of recurrent superficial bladder carcinoma. METHODS: We compared the effect of intravesical epirubicin or mitomycin C on tumor recurrence and disease free interval and their side effects after treatment of superficial bladder tumor. 47 postoperative patients with stages Ta to T1 primary superficial bladder carcinoma of grades 1 or 2 were randomized into groups A: single 80 mg epirubicin; B: 40 mg consecutive epirubicin; C: 40 mg consecutive mitomycin C. Patients were followed up for clinical, analytical, and cystoscopic evaluations every 3 months. RESULTS: The disease free intervals of the three groups were found no significant differences (F = 3.25, P > 0.05). The recurrence rate was 6.25% (1/16), 13.3% (2/15), 12.5% (2/16) (chi(2) = 0.496, P > 0.05) in groups A, B, and C at 1 year, and 33.3% (5/15), 26.7% (4/15), 25% (4/16) (chi(2) = 0.290, P > 0.05) at 3 years after operation, respectively. Side effects of group A (13.3%) were lower than those of group B (46.7%) or C (43.8%) (chi(2) = 14.56, P < 0.01). CONCLUSIONS: Single dose of epirubicin given intravesically immediately after tumor resection is effective in preventing tumor recurrence.