沙培林联合羟基喜树碱膀胱灌注与单独灌注预防膀胱癌术后复发疗效对比观察

目的：评价联合应用沙培林（OK-432）和羟基喜树碱（HCPT）膀胱腔内灌注及单独应用预防膀胱癌复发的疗效。方法：128例膀胱乳头状移行细胞癌患者行经尿道电切术和膀胱部分切除术后，随机分为3组：联合治疗组36例，OK-432组42例，HCPT、组50例。膀胱癌切除术后开始灌注，每周1次，共8周；以后每月1次，随访18个月。每2个月复查1次膀胱镜和尿细胞学检查。结果：联合应用组无复发，OK-432组3例复发，复发率7．14％（3／42），HCPT组5例复发、复发率10．00％（5／50）。OK-432组与HCPT组比较差异无统计学意义（P〉0．05）；但二者与联合组比较，组间差异有统计学意义（P〈0．05）。三组均无严重不良反应和并发症。结论：联合应用OK-432、HCPT疗效优于单独应用，预防复发疗效好，不良反应不明显，有较高临床应用价值。

Contrastive Observation on the Effect of Intravesical Instillation of Picibanil Combined with Hydroxycamptothecin or Single Instillation to Treat Postoperative Recurrence of Bladder Cancer

Objective：To evaluate the therapeutic effect of single or combinative intravesical instillation of Pici banil （OK-432） and Hydroxycamptothecin （HCPT） on postoperative recurrence of bladder transitional cell cancer. Methods：A total of 128 bladder cancers who underwent transurethral resection of bladder tumor （TURBT） and partial cystectomy were divided into 3 groups randomly ： 36 patients in the combination group received combinative instillation of OK-432 and HCPT; 42 patients in OK-432 group; 50 patients in HCPT group, Patients in all groups were treated successfully by resection of bladder cancer, then received intravesical instillation once a week in the following eight weeks, and converted to once per month. All the patients were followed up for 18 months. The cystocopy and urine cytological examination were performed once bimonthly. Results：There was no recurrence developed in combination group, 3 patients had recurrence in OK-432 group, and 5 patients had recurrence in HCPT group. The tumor recurrence rate in OK-432 group was 7.14% （3/42）, and in HCPTgroup was 10.00% （5/50）. There was no different therapeutic effect between OK 432 group and HCPT group （P〉0.05）, but the tumor recurrence rate of OK 432 group or HCPT group was significantly higher than that in combination group （P 〈0.05）. No serious adverse events and complications developed in all 3 groups. Conclusions： The therapeutic effect of combinative use was better than single use of OK-432 or HCPT. Such combination is an effective and safe treatment for preventing postoperative recurrence of superficial bladder cancer, and may potential for clinical application.