吡柔比星预防浅表性膀胱癌术后复发的效果观察

EFFECT OF PIRARUBICIN ON RECURRENT PREVENTION OF SUPERFICIAL BLADDER CANCER

目的探讨吡柔比星预防浅表性膀胱癌术后复发效果及其副作用。方法55例浅表性膀胱癌患者经尿道电切术后隨机分为观察组29例和对照组26例,观察组:吡柔比星30mg+蒸馏水30ml;对照组:塞替哌60mg+蒸馏水30ml,术后立即膀胱灌注1次,保留30min。术后1周继续灌注.每周1次,共8次,之后每月1次。比较二组术后复发及不良反应情况。结果观察组4例复发(13.8%);对照组7例复发(26.9%)。复发后肿瘤临床分期:观察组4例均为T1前期;对照组7例分别为Ta期3例、T1期1例、T2期3例。复发肿瘤病理分级:观察组G1级3例、G2级1例;对照组G1级3例、G2级1例、G3级3例。二组复发及不良反应情况比较差异有统计学意义,P<0.001。结论浅表性膀胱癌术后THP膀胱灌注能有效抑制肿瘤复发,提高患者生存率。

Objective To assess recurrent effect and treatment induced side effects of intravesically administered pirarubicin following transurethral resection of bladder（TURBT） in patients with Ta and T1 superficial bladder cancer. Methods 55 patients were divided into two groups randomly after operation. Pirarubicin 30mg plus distilled water 30ml were intravesically administered in observation group（29 cases）, and thiotepa 60mg plus distilled water 30ml were done in control group （26 cases）. The first postoperative intravesically instillation was performed immediately and was retained for 30 minutes. Continuous 8 times irrigation were performed once a week then made irrigation later once a month. The relapse and complications were compared between the two groups. Results There were 4 cases recurred in observation group（13.8%）, 7 cases did in control group（26.9 %）. Recurred clinical stage gradings of cancer were as follows： T1 former stage 4 cases in observation group; Ta stage 3 cases, T1 stage 1 case, T2 stage 3 cases in control group. Recurred pathologic gradings of cancer were as follows： G1 grade 3 cases and G2 grade 1 case in observation group; G1 grade 3 cases,G2 grade 1 case and G3 grade 3 cases in control group. There was significant difference in recurrence and complications between the two groups （P〈0. 01 ）, Conclusion Intravesically administration of pirarubicin may actively suppress the recurrence of superficial bladder cancer and increase survival rate.