吡柔比星与丝裂霉素C膀胱灌注预防TURBt术后浅表性膀胱尿路上皮癌复发的临床研究

目的:研究膀胱癌术后应用吡柔比星(THP)或丝裂霉素C(MMC)膀胱灌注预防TURBt术后浅表性膀胱尿路上皮癌复发的效果。方法:将78例膀胱癌术后患者随机分成两组,一组40例患者膀胱灌注THP,另一组38例患者膀胱灌注MMC,THP组总疗程12个月,MMC组总疗程2年,期间观察复发情况及不良反应。结果:THP组2年内复发率及不良反应发生率分别为15.0%(6/40)和27.5%(11/40);MMC组2年内复发率及不良反应发生率分别为28.9%(11/38)和31.6%(12/38)。两组肿瘤复发率有显著差异(P<0.05),不良反应发生率无明显差异(P<0.05)。结论:THP膀胱灌注化疗预防膀胱癌术后复发,较MMC疗效好,是目前较为理想的膀胱灌注药物,但是费用较高;MMC疗效虽没有THP好,但是费用较低,因而亦常用MMC作为预防膀胱癌术后复发。

Bladder instillation of pirarubicin combined with mitomycin C for prevention of TURBt postoperative superficial bladder urothelial carcinoma recurrence

Objective: To investigate the efficiency of bladder instillation of pirarubicin(THP) combined with mitomycin C(MMC) for prevention of TURBt postoperative superficial bladder urothelial carcinoma recurrence.Methods: A total of 78 patients underwent carcinoma of the urinary bladder surgery were randomly divided into two groups,one group(40 patients) was treated with bladder instillation of pirarubicin(THP) for a course of 12 months and the other(38 patients) was dealt with bladder instillation of mitomycin C(MMC) for 2 years.Recurrence and side effects were observed and compared.Results: In the THP group,2-year recurrence rate and adverse reaction rates were 15.0% and 27.5%,respectively,and the corresponding data of the MMC group were 28.9% and 31.6% of MMC group.Significant difference in recurrence rate was observed(P<0.01).Conclusions: THP bladder perfusion shows better effeciency for prevention of postoperative recurrence of bladder cancer than MMC.MMC is also commonly used because it is cheaper.