吡柔比星术后即刻膀胱灌注＋短程维持膀胱灌注化疗预防浅表性膀胱癌术后复发临床研究  

Clinical study of immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of pirarubicin after operation for preventing postoperativerecurrence of superficial bladder tumor

作　　者：陈挺[1] 牵杰[1] 蒋悦[1] 马登扬[1] 吴小芬[1] 

机构地区：[1]浙江省丽水市中心医院泌尿外科,浙江323000

出　　处：《中国医师进修杂志》2012年第17期25-27,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨吡柔比星（THP）术后即刻膀胱灌注＋短程维持膀胱灌注化疗预防浅表性膀胱癌术后复发的安全性和疗效。方法107例浅表性膀胱癌患者按随机数字表法分为术后即刻膀胱灌注＋短程维持膀胱灌注化疗组（A组，50例）和常规膀胱灌注化疗组（B组，57例）。A组术后24h内完成THP膀胱灌注，维持膀胱灌注每周1次，共8次。B组术后1～2周开始进行THP膀胱灌注，每周1次，共8次，再改为每个月1次，共10次。总疗程12个月。定期膀胱镜检查进行随访。结果术后随访13～84个月，A组膀胱局部不良反应发生率26．00％（13／50），全身症状发生率4．00％（2／50），膀胱肿瘤复发率16．00％（8，50）。B组膀胱局部不良反应发生率22．81％（13／57），全身症状发生率1．75％（1／57），膀胱肿瘤复发率19_30％（11／57），两组比较差异无统计学意义（P＞0．05）。结论THP术后aPN膀胱灌注是安全有效的，但是对膀胱穿孔明显、经尿道膀胱肿瘤切除术后膀胱黏膜创面广泛的患者，术后不宜即刻膀胱灌注化疗药物。THP术后即刻膀胱灌注＋短程维持膀胱灌注化疗预防浅表性膀胱癌术后复发的效果明确，患者耐受性好。To investigate the efficacy and safety of immediate intravesical instillationcombined with short-term maintained intravesical instillation chemotherapy of pirarubicin （THP） after operation for preventing postoperative recurrence of superficial bladder tumor. Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups： group A （50 cases） was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation, and group B （57 cases） was treated with conventional intravesical instillation chemotherapy. Patients in group A underwent intravesical instillation of THP within 24 hours, maintained intravesical instillation once a week for 8 weeks. Patients in group B underwent intravesical instillation of THP in one or two weeks after operation, once a week for 8 weeks. And then once a month for 10 months. All patients were followed up with regular cystoscopy examination. Results Patients were followed up for 13-84 months, the incidence of partial vesical toxic reaction in group A was 26.00 % （13/50）, general symptom rate was 4.00% （2/50）,the rate of recurrency was 16.00% （8/50）. The incidence of partial vesical toxic reaction in group B was 22.81% （ 13/57 ）, general symptom rate was 1.75% （ 1/57 ）, the rate of recurrency was 19.30% （11/57）. There was no significant differences between two groups （P 〉 0.05）. Conclusions Immediate intravesical instillation of THP after operation is safe and effective, but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection. Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.

关 键 词：吡柔比星 膀胱肿瘤 膀胱灌注 

分 类 号：R737.14[医药卫生—肿瘤]