诱导式卡介苗膀胱灌注预防膀胱癌术后复发的效应  

Prophylactic Effect of Inductive Intravesical Instillation of Bacillus Calmette-Guerin on Postoperative Recurrence of Bladder Cancer

作　　者：易善红[1] 叶钢[1] 王祥卫[1] 金欢胜[1] 张远宁[1] 严治林[1] 

机构地区：[1]第三军医大学新桥医院泌尿外科,重庆400037

出　　处：《癌症》2008年第11期1208-1211,共4页Chinese Journal of Cancer

摘　　要：背景与目的:膀胱灌注疗法是预防浅表性膀胱癌术后复发的重要辅助措施,但是复发率仍然较高。本研究旨在评价联合应用羟基喜树碱(hydroxycamptothecin,HYD)和卡介苗(bacillus Calmette-Guerin,BCG)膀胱腔内灌注对预防膀胱癌术后复发的疗效。方法:45例膀胱乳头状移行细胞癌患者行经尿道电切术或膀胱部分切除术后分为两组:联合治疗组24例,术后1周内行HYD膀胱腔内单次灌注,第2周后开始定期行腔内灌注BCG;BCG组21例,术后1周开始灌注BCG,并定期进行灌注治疗。定期膀胱镜检查、尿细胞学检查和随访。结果:45例术后随访24个月,BCG组3例分别于术后2、10、12个月复发,复发率14.28%(3/21),其余18例未见复发;联合治疗组未见复发,两组比较,差异有统计学意义(P<0.05)。两组均无严重不良反应和并发症。结论:HYD早期单次膀胱内灌注联合BCG定期膀胱内灌注的免疫化学疗法对预防膀胱乳头状移行细胞癌术后复发疗效较好,不良反应不明显,有较高的临床应用价值。BACKGROUND ＆ OBJECTIVE： Intravesical instillation is an important adjuvant therapy on preventing postoperative recurrence of superficial bladder transitional cell carcinoma, but the recurrence rate is still high. This study was to evaluate the prophylactic effect of intravesical instillation of hydroxycamptothecin （HYD） plus bacillus Calmette-Guerin （BCG） on postoperative recurrence of bladder transitional cell cancer. METHODS. A total of 45 bladder cancer patients who underwent TURBT or partial cystectomy were divided into two groups： 24 patients in combination group received single intravesical instillation of HYD in Week 1 after operation and regular intravesical instillation of BCG since Week 2; 21 patients in BCG group received regular intravesical instillation of BCG since Week 1 after operation. All the patients were followed up for 24 months. RESULTS： Three patients had recurrence at 2, 10, and 12 months after operation individually in BCG group; no recurrence developed in combination group. The recurrence rate was significantly higher in BCG group than in combination group （14.28% vs. 0, P〈0.05）. No serious adverse events and complication developed in both groups. CONCLUSION： Early use of single intravesical instillation of HYD plus subsequent regular intravesical instillation of BCG is markedly effective for preventing postoperative recurrence of bladder transitional cell cancer, with few adverse events.

关 键 词：膀胱肿瘤/外科手术 卡介苗 羟基喜树碱 膀胱灌注 术后复发 预防 

分 类 号：R737.14[医药卫生—肿瘤]