上尿路移行细胞癌术后预防性膀胱灌注的临床研究  

Clinical study of prophylactic intravesical chemotherapy after radical nephroureterectomy to treat upper tract urothelial carcinoma

作　　者：程树林[1] 伍鼎 黄泳富 朱平宇[1] 龚志勇[1] 

机构地区：[1]川北医学院附属医院泌尿外科,四川南充637000

出　　处：《现代肿瘤医学》2016年第21期3449-3451,共3页Journal of Modern Oncology

摘　　要：目的:探讨上尿路移行细胞癌术后预防性膀胱灌注的有效性。方法:61例上尿路移行细胞癌患者行根治性切除术,其中34例患者术后预防性使用吡柔比星膀胱灌注,27例患者单纯随访,比较两组患者2年内膀胱肿瘤的发生率以及发生时间,并观察药物灌注毒副反应发生的情况。结果:吡柔比星灌注组膀胱癌发生率为14.7%,观察随访组膀胱癌的发生率为37.0%,差异有统计学意义(P<0.05),再发时间分别为20个月和14个月,二者比较差异有统计学意义(P<0.05)。患者灌注过程中均耐受,未出现中止灌注的情况。结论:本研究初步显示,吡柔比星预防性膀胱灌注可有效减少膀胱肿瘤的发生,毒副反应少,值得临床推广。Objective To evaluate the efficacy of prophylactic intravesical chemotherapy for primary upper urinay tract urothelial cancer after nephroureterectomy. Methods ： Sicty one patients with upper urinary tract urothelial cancer were included in this study. Patients were divided into two groups. One received intravesical epirubicin instillation, another did not receive phophylactic instillation after nephroureterectomy, compared the bladder tumor recurrence rate, time to first bladder tumor recurrence. Results ： Significantly fewer patients who received epirubicin had a recurrence compared with the control group. Mean time to first bladder tumor recurrence was longer in epirubicen instillation group（ P 〈 0. 05 ） . Conclusion ： Intravesical instillation of epirubicin is well tolerated and effective for preventing blad-der recurrence and prolonging time to recurrence.

关 键 词：上尿路肿瘤 膀胱肿瘤 膀胱灌注 

分 类 号：R737.15[医药卫生—肿瘤]