THP、HCPT和MMC膀胱内灌注治疗浅表性膀胱癌疗效比较

Comparison of the therapeutic effect of three drugs by bladder instillation after transurethral resection of superficial bladder cancer

目的：比较吡柔比星（THP）、羟基喜树碱（HCPT）、丝裂霉素C（MMC）3种药物膀胱灌注治疗浅表性膀胱癌的疗效和安全性。方法：130例经尿道膀胱肿瘤电切术后的浅表性膀胱癌患者,分为THP、HCPT、MMC3组,分别采用30mgTHP＋5%葡萄糖溶液50ml、16mgHCPT＋0.9%氯化钠溶液50ml、40mgMMC＋0.9%氯化钠溶液50ml3种药物做膀胱内灌注治疗,总疗程12个月,随访3-24个月,比较3组复发率及不良反应发生情况。结果：随访24个月,THP、HCPT、MMC组的复发率分别为16.67%、17.07%、36.59%,THP、HCPT组复发率明显低于MMC组（P〈0.05）。MMC组尿路刺激症状发生率（36.59%）高于其它2组（18.75%、14.63%）（P〈0.05）。结论：浅表性膀胱癌经尿道膀胱肿瘤电切术后,应用THP膀胱内灌注可降低术后复发率。HCPT不良反应小,耐受性好,可作为临床一线用药。

Objective： Compare the effect and safety of pirarubicin （THP）, hydroxycamptothecin （HCPT） and mitomycin C（MMC）; by bladder instillation after transurethral resection of superficial bladder cancer. Methods： One hundred and thirty patients of superficial bladder cancer after transurethral resection were divided into three groups randomly. THP by bladder instillation was used in the first group, HCPT in the second group and MMC in the third. All patients were followed up for 3-24 months, The recurrent and side effects rate were observed. Results： All patients were followed up 24 months. The tumor recurrent rate in THP group, HCPT group, MMC group, were 16. 67%, 17. 07%, 36. 59%, respectively. The tumor recurrent rate of the pirarubicin and hydroxycamptothecin groups differed significantly between the mitomycin group （P d0.05）. The side effects rate of the three drugs, MMC was higher than the other two groups. Conclusions： HCPT has low side effect, better tolerated and better effect, so it may the first choice in clinical bladder instillation. Intravesical instillation of THP for patients after transurethral resection of superficial bladder cancer could decrease tumor recurrent rate, prolong the tumor-free survival period.