膀胱癌患者膀胱部分切除术后表柔比星等药物的灌注治疗

Intravesical epirubicin and other anticancer drugs instillation for bladder cancer following partial cystectomy

研究膀胱癌患者膀胱部分切除后不同药物的灌注疗效。方法 :1 6 3例膀胱癌术后患者分对照组、噻替哌组 (TsPa)、卡介苗组 (BCG)、丝裂霉素组 (MMC)、表柔比星组 (EPI) ;术后d 7经导尿管膀胱内灌注 ,除EPI5 0mg仅灌一次外 ,TsPa 6 0mg、BCG 6 0mg、MMC 2 0mg均为 1次 周× 8次 ,然后 1次 月× 1 0次 ,共 1年 ,对照组仅为术后患者。随访 6月— 6年。结果 :与其他组相比 ,对照组、TsPa组复发率高 (P <0 0 1 ) ;TsPa、BCG毒副作用强 (P <0 0 1 ) ;MMC费用高 (P <0 0 1 )。结论 :膀胱癌患者膀胱部分切除术后 ;表柔比星灌注疗效好 。

Purpose:To study the therapeutic effects of different intravesical drug instillations for bladder cancer following partial cystectomy.Methods:163 Patients were allocated to 5 groups:the control group(the patients underwent partial cystectomy alone),the thiotepa group(TsPa),the mitomycin C(MMC) group,the BCG group,the epirubicn(EPI) group.The intravesical agent was administered from the 7th day after partial cystectomy. Except for EPI 50 mg which was given only once,the TsPa 60 mg,BCG 60 mg,、MMC 20 mg instillation were repeated weekly for 8 weeks and then monthly to complete one year of treatment. All patients were followed for 6 to 72 months.Results:The recurrence rate of the control group and TsPa group were significantly higher than the BCG,MMC and EPI groups(P<0 01);The toxic and side effects in the TsPa and BCG groups were statistically significantly higher (P<0 01); The cost was significantly higher in the MMC group(P<0 01) Conclusions:The study demonstrates that epirubicin has better efficacy, lower toxicity and cost than others used as an intravesical agent following partial cystectomy.