单次腔内灌注表阿霉素预防浅表性膀胱癌术后复发的长期随访研究  

Single intravesical instillation of epirubicin for primary superficial bladder carcinoma:long-term results

作　　者：刘本春[1] 张元芳[1] 王忠[1] 丁强[1] 陈波[1] 于江[1] 张鹏[1] 

机构地区：[1]复旦大学泌尿外科研究所

出　　处：《中华泌尿外科杂志》2004年第6期380-382,共3页Chinese Journal of Urology

基　　金：卫生部部属(管)医疗机构临床学科重点项目资助(2 0 0 115 2 5 )

摘　　要：目的　探讨表阿霉素单次腔内灌注预防浅表性膀胱癌术后复发的长期随访效果。　方法　浅表性膀胱癌 (Ta～ 1,G1～ 2 ) 4 7例。男 2 9例 ,女 18例。年龄 4 5～ 79岁。随机分为 3组 ,A组 (16例 )术后 6h内单次灌注表阿霉素 80mg ;B组 (15例 ) 10d内灌注 4 0mg ,以后每周 1次 ,8～ 10次后改为每月 1次 ,至术后 1年 ;C组 (16例 )用药为丝裂霉素 ,剂量及方法同B组。采用前瞻性、随机对照临床研究 ,随访 5年 ,记录患者无瘤生存期、肿瘤复发率及不良反应发生情况。　结果　随访 5年 ,4 7例中除A组 1例死于意外、1例死于其它疾病、C组 1例死于肺癌外 ,其余 4 4例均未因膀胱癌复发死亡 ,各组患者无瘤生存期无统计学差异 (F =10 .2 8,P >0 .0 5 )。 3组患者术后 5年肿瘤复发率分别为 36 %(5 / 14 )、33% (5 / 15 )、4 0 % (6 / 15 ) ,差异无显著性意义 (χ2 =0 .83,P >0 .0 5 )。 3组患者出现药物性膀胱炎者分别为 1、2、2例 ,B、C两组各有 1例尿道狭窄。总不良反应发生率分别为 14 % (2 / 14 )、5 3% (8/15 )和 4 7% (7/ 15 ) ,A组与B、C两组相比差异有非常显著性意义 (χ2 =12 .2 1,P <0 .0 1)。　结论　表阿霉素单次腔内灌注预防浅表性膀胱癌术后复发长期效果良好。Objective To evaluate the long-term efficacy of single dose intravesical instillation of epirubicin for primary superficial bladder cancer recurrence. Methods A total of 47 postoperative patients with stages T_a to T_1 primary superficial,grades 1or 2 bladder carcinoma were randomized into study groups A single 80 mg of epirubicin,B 40 mg epirubicin consecutively,C 40 mg mitomycin C consecutively.Patients were followed up for 5 years of clinical,analytical,and cystoscopic evaluations every 3 months.The efficacy in the prevention of tumor recurrence,disease free interval and side effects of intravesical epirubicin or mitomycin C postoperatively in superficial bladder cancer were compared. Results One case of group A died of accidence,another one died of other disease.One case of group C died of lung cancer.The disease free intervals of the three groups were found to have no significant differences ( F=10.28,P > 0.05 ).The recurrence rates were 36%(5/14)、33%(5/15)、40%(6/15)at 5 years after operation,respectively(χ 2=0.83, P > 0.05 ).Side effects of group A,17%(2/14),were lower than that of group B or C,53%(8/15)and 47%(7/15),respectively(χ 2 test=12.21, P <0.01). Conclusions Single dose of epirubicin given intravesically immediately after tumor resection causes a significant and sustained effect in the prevention of primary superficial bladder cancer recurrence.

关 键 词：腔内灌注 表阿霉素 预防措施 浅表性膀胱癌 肿瘤 

分 类 号：R737.14[医药卫生—肿瘤]