膀胱灌注吡柔比星与米托蒽醌预防膀胱癌复发的临床疗效和不良反应比较

Comparison of effectiveness and adverse reactions in preventing relapse of bladder cancer with pirarubicin and mitoxatrone by using method of bladder perfusion

目的比较膀胱灌注吡柔比星和米托蒽醌预防膀胱癌复发的临床疗效与不良反应。方法 61例膀胱癌患者分为吡柔比星组（n=30,每次40 mg）和米托蒽醌组（n=31,每次20 mg）。两组患者均按常规方法和间隔时间,经导尿管行膀胱灌注1年,定期行膀胱镜检查,判定有无肿瘤复发。结果随访17~36个月。吡柔比星组和米托蒽醌组复发率分别为17%（5/30）和16%（5/31）。需治疗的不良反应分别为20%（6/30）和23%（7/31）。两组比较疗效及不良反应无显著差异（P〉0.05）。吡柔比星组出现疼痛性血尿、一过性尿失禁等不良反应较为严重;米托蒽醌组相对较轻,但出现溃疡性膀胱炎2例。结论吡柔比星、米托蒽醌膀胱灌注预防膀胱癌复发疗效相当;但米托蒽醌不良反应较轻,优于吡柔比星。

AIM To compare the effectiveness and adverse reactions of pirarubicin and mitoxatrone in preventing relapse of bladder cancer by using bladder perfusion.METHODS Sixty-one bladder cancer patients was randomly divided into the pirarubicin group（40 mg,n = 30） and mitoxantrone group（20 mg,n = 31）.All the patients were cured with bladder perfusion for 1 year according the conventional methods and intervals.Regular cystoscopy was performed to determine whether tumor recurrence.RESULTS The recurrence in the pirarubicin group and mitoxantrone group were 17%（5/30） and 16%（5/31）,respectively.The rate of adversereaction were 20%（6/30） and 23%（7/31）,respectively（P 〉0.05）.Bloody urine and urinary incontinence were more seriously in the pirarubicin group,but there were two patients occurred with ulcerative cystitis in the mitoxantrone group.CONCLUSION The method of bladder perfusion could achieve beneficial effect in preventing relapse of bladder cancer,and the adverse reactions were more superior in the mitoxantrone group than in the pirarubicin group.