浅表性膀胱癌电切术后不同膀胱化疗方案的疗效分析  

The clinical investigation of different intravesical instillation of chemotherapy after transurethral resection of bladder tumors for the treatment of superficial bladder cancer

作　　者：屠凡倬[1] 沈周俊[1] 王先进[1] 钟山[1] 朱照伟[1] 王浩飞[1] 徐兆平[1] 周文龙[1] 吴瑜璇[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《国际泌尿系统杂志》2012年第2期193-196,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨表浅性膀胱癌患者行经尿道膀胱肿瘤电切术（TURBT）后灌注膀胱化疗药物盐酸吡柔比星（THP）、羟基喜树碱（HCPT）或序贯灌注THP＋HCPT序贯灌注用于防治术后复发的疗效。方法应用THP、HCPT及THP＋HCPT序贯法组合行TURBT后膀胱内灌注，长期随访患者资料，观测其在0．5、1、2、3、4、5年时的肿瘤复发率。结果随访术后3～60个月。THP、HCPT、序贯组和对照组患者在6个月内复发率分别为4例（8．2％）、3例（7．3％）、1例（2．5％）和4例（19．0％）；1年内复发率分别为5例（10．2％）、4例（9．8％）、2例（5．0％）和9例（42．9％）；2年内复发率分别为7例（14．3％）、6例（14．6％）、2例（5．0％）和11例（52．4％）；3年内复发率分别为9例（18．4％）、9例（22．0％）、4例（10．0％）和12例（57．1％）；4年内复发率分别为11例（22．5％）、10例（24．4％）、6例（15．0％）和14例（66．7％）；5年内复发率为12例（24．3％）、11例（26．8％）、7例（17．5％）和15例（71．4％）。结论浅表膀胱癌在TURBT后行膀胱腔内序贯灌注THP＋HCPT疗法预防膀胱癌术后复发疗效确定，较单用THP或HCPT复发率低，毒副作用无差异。是更有效的膀胱灌注疗法。Objectives To investigate the efficacy and safety of intravesical instillation of pirarubicin hydrochloride（ THP）, hydroxycamptothecine（HCPT） or THP associated with HCPT after Transurethral Resection of Bladder Tumors （TURBT） for the treatment of Superficial Bladder cancer. Methods From Jan. 2003 to Oct. 2010, a total of 111 patients with newly diagnosed superficial bladder cancer undergone TURBT. The intravesical instillation of THP, HCPT, THP associated with HCPT and control was in 49, 41, 40 and 21 patients with bladder cancer after TURBT. The patients were received cystoscopy examination periodically to observe the recurrence rate at 0.5, 1, 2, 3, 4 and 5 years. Results The patients were followed up for 3 to 60 months, the 0.5 - year recurrence rate of the patients in the THP group, HCPT group, THP associated with HCPT and control group were 8.2%, 7.3%, 2.5% and 19.0%, the 1 - year recurrence rate were 10.2%, 9.8%, 5% and 42.9%, the2 - year recurrence rate were 14.3%, 14.6%, 5% and 52.4%, the 3 - year recurrence rate were 18.4%, 22.0%, 10% and 57.1%, the 4 - year recurrence rate were 22.5%, 24.4%, 15% and 66.7%, and the 5 - year recurrence rate were 24.3%, 26.8%, 17.5% and 71.4% respectivelyConclusions The intravescal instillaton of THP associ- ated with HCPT is an effective and safe treatment for superficial bladder cancer. It may be a potential better method of intravescial instillation of bladder cancer.

关 键 词：膀胱肿瘤 电外科手术 

分 类 号：R737.14[医药卫生—肿瘤]