肌层非浸润性膀胱癌术后即刻单次灌注吡柔比星与多次灌注疗效的比较  

Comparison of the clinical outcome of instant single intravesical instillation of pirarubicin and multiple instillations after TUR-Bt for preventing recurrence of non muscle-invasive bladder cancer

作　　者：徐欢[1] 曹明[1] 陈海戈[1] 薛蔚[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,上海200127

出　　处：《肿瘤》2008年第10期889-891,共3页Tumor

摘　　要：目的：比较肌层非浸润性膀胱癌经尿道膀胱肿瘤电切术（transurethral resection of bladder tumor，TUR—Bt）后即刻单次膀胱内灌注吡柔比星（pirarubicin，THP）与术后2周开始多次灌注方案对预防肿瘤术后复发的疗效及安全性。方法：2003年3月—2005年6月162例肌层非浸润性膀胱癌被随机分为2组：术后即刻单次灌注组（RG组）80例，术后2周起多次定期灌药组（CG组）82例，比较2组肿瘤的复发率和不良反应。结果：共6例失随访，有效随访病例2组各78例，随访期24—48个月。RG组20例肿瘤复发、CG组14例复发，差异无统计学意义。RG组中病理级别较高的G2、G3级肿瘤复发率42．5％（17／40），CG组中G2、G3复发率20．9％（9／43），多次灌药组复发率低于术后即刻单次灌药组。结论：与术后2周开始多次定期灌药化疗相比，术后即刻单次灌注化疗预防肿瘤复发的总体效果可能相似。但对于病理级别较高的肌层非浸润性膀胱癌（G2和G3），多次灌药也许可更好地减少术后肿瘤复发率。Objective：To compare the effectiveness and security of instant single intravesieal instillation of pirarubiein and multiple instillations at two weeks after transurethral resection of bladder tumor （TUR-Bt） for prevention of non muscle-invasive bladder cancer recurrence. Methods：We recruited 162 non muscle-invasive bladder cancer patients from Mar 2003 to Jun 2005. They were ran- domly divided into 2 groups： 80 cases received instant single intravesical instillation of pirarubicin post operation （ group RG） and 82 cases were given multiple intravesieal perfusions of pirarubicin regularly after two weeks of operation （group CG）. The recurrence rates and side effects between the two groups were compared. Results：Totally six patients lost follow-up. The two groups both had 78 valid follow-up cases. The follow-up period was 24 to 48 months. The recurrence rate was 25.6% （20/78） in group RG, and 17.9% （ 14/ 78） in group CG. There was no significant difference between the two groups. The recurrence rates of G2 and G3 tumor were 42.5% （17/40） in group RG, and 20.9% （9/43） in group CG. The recurrence rate of group CG was lower than that in group RG in subset tumor at higher grade （ G2 and G3 ）. Conclusion：The total effectiveness of instant single intravesical instillation of chemotherapy is similar to multiple instillations of chemotherapy after two weeks of TUR-Bt for preventing the recurrence of non muscle-invasive bladder cancer. But multiple instillations can better decrease the recurrence of non muscle-invasive bladder cancer at higher pathological grade （ G2 and G3）.

关 键 词：膀胱肿瘤 化学疗法 肿瘤 局部灌注 随访研究 吡柔比里 

分 类 号：R737.14[医药卫生—肿瘤] R730.58[医药卫生—临床医学]