浅表性膀胱癌经尿道术后早期灌注化疗临床预后的系统评估  

Early Intravesical Chemotherapy after Transurethral Resection of Non-Muscle-Invasive Bladder Cancer: A Systematic Review

作　　者：李涛[1] 杨立[1] 明星[1] 王志平[1] 

机构地区：[1]兰州大学泌尿外科研究所,兰州大学第二医院泌尿外科,甘肃省泌尿系统疾病临床医学中心,甘肃省泌尿系统疾病研究重点实验室

出　　处：《循证医学》2013年第3期147-151,共5页The Journal of Evidence-Based Medicine

摘　　要：目的系统评价浅表性膀胱癌经尿道术后早期灌注化疗对肿瘤复发及进展的影响。方法检索PubMed、EMBASE、CNKI、VIP及万方数据库,检索时间从建库至2012年4月,收集浅表性膀胱癌经尿道术后早期灌注化疗的随机对照试验。由2名研究者按照纳入排除标准筛选文献,评价质量并应用RevMan5.0进行Meta分析。结果经过评价共纳入4个随机对照研究,合计909例浅表性膀胱癌患者。Meta分析显示:术后灌注可降低肿瘤复发率(比值比0.46,95%可信区间0.22～0.99,P=0.05);而在改善肿瘤进展及降低死亡方面无此效应(比值比0.59,95%可信区间0.20～1.72,P=0.34)。结论浅表性膀胱癌经尿道术后早期行化疗药物灌注,对降低肿瘤复发率有一定的作用,但不能改善肿瘤的进展及降低死亡率,化疗药物的副作用对患者的生活质量会产生不良影响。Objective To evaluate the recurrence and progression of tumors treated with early intravesical chemotherapy after transurethral resection of non-muscle-invasive bladder cancer （TUR-bt）. Methods Randomized controlled trials （RCTs） about early intravesical chemotherapy after TUR-bt were retrieved on PubMed, EMBASE, CNKI, VIP and Wanfang databases from their establishment to April 2012. According to the inclusion and exclusion criteria, two reviewers independently screened the trials, extracted the data, assessed the quality, and conducted the meta-analysis with Revman 5.0 software finally. Results A total of four RCTs involving 909 superficial bladder cancer patients were eligible. The results of meta-analysis showed that there was statistical difference in tumor recurrence（OR= 0.46, 95%CI 0.22-0.99 P=0.05）. However, the effect of progression and reducing the death rate showed no signifi- cant difference with or without early instravesical chemotherapy （OR=0.59, 95%CI 0.20-1.72, P=0.34）. Conclusion Early instravesical chemotherapy after TUR-bt is effective in reducing the tumor recurrence. By contrast, it could not lower the progression and death rate, and the side effects of chemotherapy agents could effect the quality of life of patients.

关 键 词：浅表性膀胱癌 化疗 临床预后 随机对照试验 Meta分析 

分 类 号：R737.14[医药卫生—肿瘤]