不同药物的膀胱灌注化疗治疗非肌层浸润性膀胱癌的临床效果  

Clinical efficacy of bladder perfusion chemotherapy with different drugs in the treatment of non muscle invasive bladder cancer

作　　者：张源锋[1] 张永海[1] 徐庆春[1] 林伟强[1] 黄洪[1] 蓝开健 池泽湃 ZHANG Yuanfeng;ZHANG Yonghai;XU Qingchun;LIN Weiqiang;HUANG Hong;LAN Kaijian;CHI Zepai(Department of Urology,the Shantou Central Hospital,the Affiliated Shantou Hospital of Sun Yatsen university,Shantou 515031,China)

机构地区：[1]广东省汕头市中心医院(中山大学附属汕头医院)泌尿外科,广东汕头515031

出　　处：《中国医药科学》2018年第13期31-34,共4页China Medicine And Pharmacy

摘　　要：目的探讨在保留膀胱术后采取不同的药物进行膀胱灌注化疗对非肌层浸润性膀胱癌的临床效果。方法选择我院2013年1月~2016年1月收治的膀胱肿瘤患者230例,采用经尿道膀胱肿瘤电切术或膀胱部分切除术等保留膀胱手术,病理证实为非肌层浸润性膀胱癌(T1,Ta),术后分为三组,分别采用吡柔比星(Pirarubicin,THP组)(85例),表柔比星(Epirubicin,EPI组)(65例)、丝裂霉素(Mitomycin,MMC组)(80例),进行膀胱内灌注,进一步对比肿瘤复发率以及不良反应。结果三组患者术后2年的肿瘤复发率相比有统计学差异(P<0.05)。三组患者用药后的化学性膀胱炎发生率、血尿发生率、尿道狭窄发生率等比较差异无统计学意义(P>0.05)。结论对于采用保留膀胱手术治疗的非肌层浸润性膀胱癌患者术后应用THP、EPI膀胱内灌注治疗,能降低术后复发率;应用MMC膀胱灌注,术后复发率较前两者高,但费用低廉,临床上根据病情适当选用。Objective To evaluate the efficacy and safety of bladder perfusion chemotherapy with different drugs after bladder preserving operation in the patient with non muscle invasive bladder cancer.Methods From January 2013 to January 2016,230 patients which were diagnosed with bladder cancer in our hospital were selected.All patients underwent transurethral resection of bladder tumor or partial cystectomy,and bladder preservation was confirmed,The pathological diagnosis was non muscle invasive bladder cancer(T1,Ta).After operation,all them were divided into three groups,with pirarubicin(Pirarubicin,group THP),85 cases,epirubicin(Epirubicin,group EPI),65 cases,and mitomycin(Mitomycin,group MMC),80 cases,and intravesical perfusion was carried out.The recurrence rate and adverse effect of the three groups were compared.Results There was a significant difference in recurrence rate between the three groups 2 years after operation(P<0.05).There was no significant difference in incidence of chemical cystitis,incidence of hematuria and incidence of urethral stricture between the three groups(P>0.05).Conclusion THP and EPI intravesical instillation for non myometrium invasive bladder cancer patients with retention bladder surgery can reduce the recurrence rate after operation,and the recurrence rate after MMC bladder perfusion is higher than that of the previous two,but the cost is low,and it is suitable to be selected according to the condition of the disease.

关 键 词：非肌层浸润性膀胱癌 膀胱灌注 吡柔比星 表柔比星 丝裂霉素 

分 类 号：R737.14[医药卫生—肿瘤]