吡柔比星联合聚维酮膀胱灌注预防浅表膀胱癌复发

Intravesical Instillation of Pirarubicin (THP) Together with Polyvinylpyrrolidone (PVP) in the Prevention of Postoperative Recurrence of Superficial Bladder Cancer

背景与目的:膀胱癌术后易复发,且可恶性进展,影响预后。如何预防其复发一直为学者们所关注,本研究探讨吡柔比星(pirarubicin,THP)联合聚维酮(polyvinylpyrrolidone,PVP)膀胱灌注预防浅表膀胱癌复发的疗效及副作用。方法:1999年10月～2002年5月,选择34例浅表膀胱癌术后患者,将20mgTHP溶解于10ml生理盐水和20mlPVP中,然后经导尿管注入膀胱并保留1小时。结果:所有患者随访5～26个月,平均随访17.2个月。2例复发,复发率5.8%。4例血尿,膀胱刺激症6例(17.6%)。结论:THP联合PVP膀胱灌注预防浅表膀胱癌复发疗效确切,副作用少。

BACKGROUND ＆OBJECTIVE: Superficial bladder transitional cell carcinoma is aggressive and tends to recurrence after operation. In order to prevent the relapse of bladder neoplasms,this study was designed to explore the effect of intravesical instillation of pirarubicin(THP) together with polyvinylpyrro lidone (PVP) on patients with superficial bladder cancer who had undergone surgical operation. METHODS: A total of 34 cases were enrolled from October 1999 to May 2002. After one week of operation, pirarubicin (20 mg) dissolved in 10 ml normal saline plus 20 ml PVP was instilled into bladder, and was retained for 60 minutes. In the following 7 weeks, intravesical instillation of pirarubicin was administered once a week. Subsequently it was done bi monthly, finally once a month for 6 months. RESULTS: Follow up was performed for 5 26 months (mean:17 2 months). Among the 34 cases, recurrence was found in 2 cases (5 8％),bladder irritation in 6 cases (17 6％) and hematuria in 4 cases (11 7％) as well. CONCLUSION: Intravesical instillation of THP/PVP is effective for prevention of postoperative recurrence of superficial bladder cancer with fewer side effects. Further study is needed for wide use in such way.