吡柔比星膀胱灌注化疗预防TURBt术后复发疗效分析

The effects of bladder irrigation with THP on preventing recurrence of BTCC after TURBt

目的探讨吡柔比星(tetrahydropyranyladriamycin,THP)膀胱灌注化疗预防表浅性膀胱癌术后复发的临床疗效。方法本组共收集表浅性膀胱癌患者共32例,均采用经尿道膀胱肿瘤切除术(transurethral resection of bladdertumor,TURBt)进行治疗,术后用THP膀胱灌注化疗预防肿瘤复发。术后随访6～12个月,观察患者肿瘤复发、毒副作用发生情况。结果所有患者THP膀胱灌注化疗期间无发热、呕吐、血常规异常;出现尿频、尿急、尿痛5例,嘱多饮水,并予碱化尿液、止痛、黄酮哌酯片等对症处理后症状消失;术后复发3例,其中2例再次行TURBt+THP膀胱灌注化疗,1例行膀胱部分切除+THP膀胱灌注化疗,随访期间无再复发。结论 THP预防表浅性膀胱癌TURP术后复发疗效可靠,副反应少且轻,值得在临床上推广应用。

Objective The study attempted to understand the effects of bladder irrigation with tetrahydropyranyladriamycin（THP） on preventing recurrence of superficial bladder transitional cell carcinoma（BTCC） after transurethral resection of bladder tumor（TURBt）.Method In the present study,data of 32 patients with superficial BTCC were collected,and they were all treated with TURBt.After the operation,the patient were treated with bladder irrigation with THP to prevent recurrence of the tumor.All the patients were followed up for 6-12 months,and the tumor recurrence and toxic and side-effects of the irrigation were observed.Results During the irrigation,all the patients had no fever,vomiting and abnormal regular blood test.5 patients had frequent micturition,urgent micturition and urodynia.They were required to drink more water,alkalified in urine and prescribed for flavoxate,and the urination symptoms were relieved.3 patients experienced recurrence of bladder tumor.2 of them were re-treated with TURBt＋THP irrigation and the third was treated with partial resection of bladder＋THP irrigation.All the recurrent patients had no re-recurrence during the follow-up.Conclussion The therapeutic effects of TURBt＋bladder irrigation with THP is reliable,of few and light adverse reaction.The method is worthy of being generalized for the treatment of BTCC.