膀胱内单纯化疗与联合免疫化疗预防膀胱癌复发的疗效分析

Analysis of prophylactic intravesical chemotherapy for bladder cancer recurrent after TUR with or without immunotherapy

目的：探讨降低非浸润性膀胱移行细胞癌经尿道手术后复发率的有效方法。方法：1995年1月～2002年12月205例非浸润性膀胱移行细胞癌患者，行经尿道膀胱肿瘤切除术后膀胱灌注治疗预防复发。单纯以丝裂霉素30mg膀胱灌注（A组）120例；以丝裂霉素30mg膀胱灌注，联合肌注白介素-2和γ-干扰素（B组）85例。比较两组随访期内复发率。结果：所有患者均随访2年以上，A组膀胱癌的复发率为42．5％，B组复发率为25．9％（P＜0．01）。结论：丝裂霉素膀胱灌注联合肌注白介素-2和γ-干扰素能有效降低非浸润性膀胱移行细胞癌的复发率。

Objective：To compare the effect of intravesical chemotherapy with or without immunotherapy for prevention of superficial bladder cancer recurrence after TUR. Methods： From Jan. 1995 to Dec. 2002, intravesical instillation of mitomycin C （MMC） was used in 205 cases for prophylaxis of bladder cancer recurrence, with immunotherapy （plus intramuscular injection of interleukin-2 and γ-interferon） 85 cases or without immunotherapy 120 cases. The tumor recurrent rates were compared between two groups. Results：All cases were followed-up more than two years. The recurrent rates of transitional cell carcinoma of the bladder in the groups with or without im- munotherapy were 25.9% and 42.5%. respectively. The differences of two groups were significant statistically （P〈0.01）. Conclusions： Intravesical instillation of MMC combined with injection of IL-2 and γ-IFN can significantly decrease the recurrent rates of the bladder cancer after TUR treatment.