盐酸米托蒽醌膀胱灌注预防尿路上皮移行细胞癌复发

Clinical study of intravesical mitoxantrone for prophylaxis against recurrence of transitional cell carcinoma

目的 :评价盐酸米托蒽醌膀胱灌注预防尿路移行上皮细胞癌膀胱内复发的有效性、患者耐受性及其毒副作用。方法 :对 2 1例手术后经病理检查证实为尿路上皮移行细胞癌而且保留膀胱的患者 ,以盐酸米托蒽醌作膀胱灌注 ,记录膀胱灌注过程中的相关情况。结果 :随访 1～ 12个月 ,4例复发 ,1例恶化 ,复发率为 19.0 % (4 /2 1) ,1年未复发率 76 .2 % (16 /2 1) ,平均无瘤间期 10 .3个月。 9例发生局部并发症 ,复查血常规及肝、肾功能灌注前后差异无统计学意义。结论 :初步随访证实 ,盐酸米托蒽醌降低尿路上皮移行细胞癌术后复发 ,大部分患者耐受良好 ,无明显全身毒副作用。

Objectives: To evaluate the efficacy of intravesical mitoxantrone for prophylactic treatment against intravesical recurrence of urothelial transitional cell carcinoma (TCC) after transurethral resection of bladder tumor(TURBT) or partial cystectomy, and assess its systemic toxicity and local side effects. Method: 21 patients received 10mg mitoxantrone in 40ml normal saline early after the operation intravesically, the toxicity and the side effects during intravesical administrations were recorded. Results: After 1 to 12 months follow-up, tumor recurred in 4 of 21 patients, 1 patient deteriorated. Mean tumor-free interval was 10.3 months. The rate of one year tumor-free was 74.2 %(16/21), the recurrence rate was 19%(4/21). Only 9 patients have slight local side effects. There were no statistically difference between pre-treatment and post-treatment parameters.Conclusion:Intravesical mitoxantrone can reduce the incidence of tumor recurrence in some patients on a short-term basis, but some patients may not respond to intravesical mitoxantrone. 10 mg mitoxantrone diluted in 40 ml normal saline can be administered without significant systemic and local toxicity, intravesical mitoxantrone was tolerated well by the majority of patients.