不同化疗药膀胱灌注预防浅表性膀胱癌术后复发的效果观察

Observation on Efficacy of Different Chemotherapeutics for Bladder Perfusion in Prevention of Recurrence After Surgery for Superficial Bladder Cancer

目的:探讨不同化疗药膀胱灌注预防浅表性膀胱癌术后复发的效果。方法:选取2012年2月11日至2015年6月20日大同市第五人民医院收治的浅表性膀胱癌患者96例,以随机数字表法分为观察组和对照组,每组48例。两组患者均实施经尿道膀胱肿瘤切除术,观察组患者给予羟基喜树碱灌注化疗,对照组患者给予丝裂霉素灌注化疗。比较两组患者治疗前后的成纤维细胞生长因子(FGF)、血管内皮生长因子(VEGF)及基质金属蛋白酶9(MMP-9)水平的差异;随访3年,观察两组患者的复发情况、生存情况及不良反应发生情况。结果:治疗后,观察组患者FGF、VEGF及MMP-9水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的1、2和3年生存率明显高于对照组,复发率明显低于对照组,差异均有统计学意义(P<0.05);观察组、对照组患者的不良反应发生率分别为16.67%(8/48)、20.83%(10/48),差异无统计学意义(P>0.05)。结论:与丝裂霉素灌注化疗相比,羟基喜树碱灌注化疗用于经尿道膀胱肿瘤切除术的浅表性膀胱癌患者的效果更好,更有助于提高患者生存率,减少复发率,且安全性较高。

OBJECTIVE: To probe into the efficacy of different chemotherapeutics for bladder perfusion in prevention of recurrence after surgery for superficial bladder cancer. METHODS: 96 patients with superficial bladder cancer admitted into the Fifth People’s Hospital of Datong from Feb. 11 th, 2012 to Jun. 20 th, 2015 were selected and divided into observation group and control group via random number table, with 48 cases in each group. Transurethral resection of bladder tumor was performed in both groups, the observation group was given hydroxycamptothecin for infusion chemotherapy, while the control group was given mitomycin. Differences in fibroblast growth factors(FGF), vascular endothelial growth factor(VEGF) and matrix metalloproteinase 9(MMP-9) levels between two groups before and after treatment were compared, the recurrence rates, survival rates and incidences of adverse drug reactions of the two groups were observed in 3-year follow-up. RESULTS: After treatment, the FGF, VEGF and MMP-9 levels of observation group were significantly lower than those of the control group, with statistically significant differences(P<0.05);the 1-year, 2-year and 3-year survival rates of observation group were significantly higher than those of the control group, the recurrence rate of observation group was significantly lower than that of the control group, with statistically significant differences(P<0.05);the incidences of adverse drug reactions of observation group and control group were respectively 16.67%(8/48) and 20.83%(10/48), the difference had no statistical significance(P>0.05). CONCLUSIONS:Compared with mitomycin for infusion chemotherapy, hydroxycamptothecin has better efficacy on patients with superficial bladder cancer undergoing transurethral resection of bladder tumors, which helps to improve survival rate, reduce recurrence rate with high safety.