羟基喜树碱和吡柔比星组合膀胱灌注预防表浅性膀胱癌术后复发

EFFECT OF INTRAVESICAL INSTILLATION OF HYDROXYCAMPTOTHECIN AND PIRARUBICIN FOR PREVENTING POSTOPERATIVE RECURRENCE OF SUPERFICIAL BLADDER CANCER

目的探讨羟基喜树碱(HCPT)和吡柔比星(THP)组合膀胱灌注预防表浅性膀胱癌术后复发的效果和安全性。方法应用HCPT、THP及HCPT+THP同时法和HCPT+THP序贯法组合行膀胱癌患者电切或部分切除后膀胱内灌注,随访2年,记录每次膀胱灌注后的局部及全身反应情况,3个月行1次膀胱镜复查。结果HCPT+THP序贯法膀胱灌注,2年后膀胱癌复发率7.5%,明显低于单用HCPT/THP和HCPT+THP同时法;而HCPT+THP序贯法膀胱灌注,其尿路刺激征、血尿及肝肾功能等毒副作用与单用HCPT和TH无显著性差别。结论HCPT+THP序贯法膀胱灌注预防表浅性膀胱癌术后复发效果好,较单用HCPT/THP和HCPT+THP同时法其复发率低,而毒副作用无显著性差异,因此是一种更有效的灌注方法。

objective To observe the effect and safety of intravesical instillation of hydroxycamptothecin （HCPT） and pirambicin（THP） for preventing postoperative recurrence of the superficial bladder cancer. Methods The intravesical instillation of HCPT, THP , HCPT ＋ THP and HCPT associated with THP was performed in 35,40, 40 and 40 patients with bladder cancer after operation and till two years after operation. The local and overall reaction was recorded for each instillation. The cystoscopy was performed once every three months. All the patients were followed up for 24 months. Results The Recurrence of bladder cancer patient after intravesical instillation HCPT associated with THP is lowest （7.5%）, which is lower than HCPT, THP , HCPT ＋THP . The adverse reaction rate, such as urinary irritation symptoms, hemuresis, renal function and hepatic function of HCPT associated with THP is not significant higher than HCPT, THP , HCPT ＋ THP. Conclusion The intravesical instillation of HCPT associated with THP is an effective and safe treatment for superficial bladder cancer. It may be a potential better method of intravesical instillation for bladder cancer.