膀胱热灌注化疗对非肌层浸润性膀胱癌TUR-BT术后预防复发的观察

Preventive Effect of Bladder Hyperthermic Perfusion Chemotherapy on Recurrence of Non-muscle Invasive Bladder Cancer After TUR-BT

目的研究膀胱热灌注化疗对非肌层浸润性膀胱癌经尿道膀胱肿瘤电切术(TUR-BT)术后复发的预防效果,为患者的术后辅助治疗提供指导。方法选取我院于2015年1月至2017年1月收治的82例非肌层浸润性膀胱癌患者进行研究,按照随机数字表法,随机分为治疗组(n=41)和对照组(n=41)。两组患者均行TUR-BT术,术后对照组行常规膀胱灌注化疗,治疗组行膀胱热灌注化疗。治疗过程中及随访期间,观察并比较两组患者临床治疗效果、术后2年内复发情况以及不良反应发生情况。结果灌注化疗后随访12~24个月,治疗组1年复发率、2年复发率以及总体复发率分别为0%、7.32%以及7.32%,对照组1年复发率、2年复发率以及总体复发率分别为14.63%、31.71%以及46.34%,两组比较差异有统计学意义(P<0.05)。治疗组不良反应发生率(9.76%)与对照组(19.51%),比较差异无统计学意义(P>0.05)。结论膀胱热灌注化疗对非肌层浸润性膀胱癌TUR-BT术后复发的预防效果较好,可减少患者2年内复发率,且不增加不良反应,较为安全,值得临床推广应用。

Objective To study the preventive effect of bladder hyperthermic perfusion chemotherapy on recurrence of non-muscle invasive bladder cancer after TUR-BT and to provide guidance for postoperative adjuvant treatment.Methods 82 patients with non-muscle invasive bladder cancer admitted to our hospital from January 2015 to January 2017 were enrolled in the study.They were randomly divided into treatment group(n=41)and control group(n=41)by using random number table.Both groups were treated with transurethral resection of bladder tumor(TUR-BT).The control group was treated with intravesical chemotherapy and the treatment group was treated with bladder hyperthermic perfusion.During the treatment and the follow-up period,the clinical treatment effect,recurrence and adverse reactions within 2 years after the operation were observed and compared between the two groups.Results After perfusion chemotherapy from 12 to 24 months,the 1-year recurrence rate,2-year recurrence rate,and overall recurrence rate of the treatment group were 0%,7.32%,and 7.32%respectively.The 1-year recurrence rate,2-year recurrence rate and overall recurrence rate of the control group were 14.63%,31.71%and 46.34%respectively.The differences between the two groups were significant(P<0.05).The adverse reactions in both groups were urinary urgency,frequent urination,urinary tingling and other bladder irritation.The incidence of adverse reactions in the treatment group(9.76%)was not significantly different from that in the control group(19.51%)(P>0.05).Conclusion Bladder hyperthermic perfusion chemotherapy has a better preventive effect on the recurrence of non-muscle invasive bladder cancer after TUR-BT.It can reduce the recurrence rate within 2 years and does not increase adverse reactions.Therefore,it is safe and worthy of clinical application.