吡柔比星不同灌注方法对膀胱癌术后复发的影响

Effect of different pirarubicin perfusion methods on recurrence of bladder cancer

目的观察吡柔比星不同方法膀胱内灌注对膀胱癌术后复发的影响。方法选取70例浅表性膀胱癌患者,随机分为对照组与观察组,每组35例,两组患者灌注前少量饮水,均于术后1周开始行灌注治疗,观察组患者采用40 mg吡柔比星+80 mL蒸馏水进行膀胱内灌注治疗,每周治疗1次,连续治疗8周。对照组患者前8次灌注同观察组,在治疗8周以后每1个月行灌注治疗1次,连续治疗10个月。观察两组患者的临床疗效及术后1年局部和全身不良反应发生情况,观察两组患者术后2年内膀胱癌复发率。结果观察组治疗的总有效率(91.43%)明显高于对照组(74.29%),两组比较差异有统计学意义(P<0.05)。观察组随访2年术后膀胱癌复发率为14.28%,对照组为11.43%,两组复发率比较差异无统计学意义(P>0.05)。观察组共6例(17.14%)发生不良反应,对照组15例(42.86%)发生不良反应,观察组不良反应发生率明显低于对照组(P<0.05)。结论采用吡柔比星进行为期8周的膀胱内灌注治疗,控制膀胱癌术后复发效果满意,而且不良反应少,患者耐受性好。

Objective To observe the effect of different pirarubicin perfusion methods on recurrence of blad- der cancer. Methods 70 patients with superficial bladder cancer were randomly divided into control group and obser- vation group ,35 cases in each group. Before pouring,the patients of the two groups drank a small amount of water. Af- ter 1 week of the operation, the infusion therapy started. Observation group was treated with 40 mg pirarubicin plus 80 rnL distilled water intravesical therapy, once a week, for 8 weeks. The treatment of the control group was similar as the observation group for 8 weeks, then a monthly infusion therapy was given, the treatment was lasted for 10 months. The clinical efficacy, adverse reactions and bladder cancer recurrence rate within 2 years of the two groups were observed. Results The total efficacy of observation group （ 91.43% ） was significantly higher than that of control group （74. 29% ） , there was significant difference between the two groups （P 〈 0. 05 ）. The bladder cancer recurrence rate of 2-year follow-up of observation group was 14. 28% , while it was 11.43% in control group, there was no significant difference between the two groups （ P 〉 0. 05 ）. There were 6 cases （ 17. 14% ） and 15 cases （42.86%） of ADR in treatment group and control group, there was significant difference between the two groups （ P 〈0. 05 ）. Conclusion Pirarubicin intravesical infusion therapy for 8 weeks can control the recurrence of bladder cancer with less adverse reactions.