老年浅表性膀胱癌病人尿道膀胱肿瘤电切术后即刻吡柔比星热灌注与常规灌注的临床观察

Clinical observation of immediately hyperthermic intravesical chemotherapy with pirarubicin versus traditional intravesical instillation with pirarubicin after transurethral resection of the bladder tumor in elderly patients with superficial bladder cancer

目的探究尿道膀胱肿瘤电切术(TURBT)后吡柔比星即刻膀胱热灌注化疗与常规膀胱灌注化疗对老年浅表性膀胱癌病人的疗效。方法选取2014年10月至2016年10月北京老年医院收治的老年浅表性膀胱癌病人74例,采用随机数字表法将研究对象分为观察组(38例)和对照组(36例),所有病人均行TURBT。观察组术后6 h内行即刻吡柔比星膀胱热灌注,并行长期膀胱热灌注化疗,对照组术后1周行长期吡柔比星常温膀胱灌注化疗,随访比较2组病人的肿瘤复发率和不良反应发生情况。结果全部病例随访24个月,观察组膀胱癌复发率显著低于对照组(P<0.05),观察组总不良反应发生事件次数显著低于对照组(P<0.05)。结论 TURBT后即刻吡柔比星膀胱热灌注化疗是预防老年浅表性膀胱癌病人术后复发的有效方法。

Objective To compare the efficacy of immediately hyperthermic intravesical chemotherapy with pirarubicin versus traditional intravesical instillation with pirarubicin after transurethral resection of the bladder tumor（ TURBT） for elderly patients with superficial bladder cancer. Methods A total of 74 cases of elderly patients with superficial bladder cancer treated with TURBT in Beijing Geriatric Hospital from October 2014 to October 2016 were selected,and the subjects were randomly divided into the observation group（ 38 cases） and control group（ 36 cases）. The observation group was treated with immediately hyperthermic intravesical chemotherapy with pirarubicin in 6 h after surgery,then was treated with prolonged hyperthermic intravesical chemotherapy. The control group was treated with prolonged intravesical instillation of pirarubicin at normal temperature one week after surgery. The incidence rate of tumor recurrence and the adverse reaction were compared between the two groups. Results All patients were followed up for 24 months. The bladder cancer recurrence rate in the observation group was significantly lower than that in the control group（ P〈0. 05）,and the number of total adverse reaction in the observation group was significantly lower than that in the control group（ P〈0. 05）. Conclusions Immediately hyperthermic intravesical chemotherapy with pirarubicin after TURBT is an effective method to prevent postoperative recurrence in elderly patients with superficial bladder cancer.