摘要
目的:比较苯扎溴铵(benzalkonium bromide,BB)、吡喃阿霉素(pirarubicin,THP)、丝裂霉素C(mitomycin C,MMC)3种药物分别行膀胱内灌注,以预防浅表性膀胱移行细胞癌(superficial bladder transient cell carcinoma,SBTCC)术后复发的有效性和安全性。方法:将127例SBTCC术后患者随机分成3组:(1)BB组43例,术后立即给予膀胱内灌注0.1%BB300mL,并保留灌注液15min,共1次;(2)THP组42例,给予膀胱内灌注THP30mg(溶于50mL质量浓度为0.9%的氯化钠溶液);(3)MMC组42例,给予膀胱内灌注MMC40mg(溶于50mL质量浓度为0.9%的氯化钠溶液)。THP组和MMC组均为每周灌注给药1次,共8次,随后改为每月1次,持续1年。对患者定期随访行膀胱镜检查,并比较3组患者的肿瘤复发率以及不良反应。结果:术后随访24个月后,BB、THP和MMC组的肿瘤复发率分别为4.7%、23.8%和26.2%,BB组明显低于THP和MMC组(P<0.005),THP和MMC组的差异无统计学意义(P>0.05)。肿瘤病理分级、临床分期、初发与复发肿瘤及不同灌注药物对复发率的影响差异有统计学意义(P<0.05)。BB、THP和MMC组的下尿路症状发生率分别为4.7%、23.8%和28.6%,BB组明显低于其他2组(P<0.05)。BB组血尿以及血白细胞计数低于正常水平的发生率均明显低于THP和MMC组(P<0.05)。3组的肝肾功能受损发生率差异无统计学意义(P>0.05)。结论:BB膀胱灌注预防SBTCC术后复发的疗效较THP和MMC好,且费用低廉,无明显全身不良反应,耐受性好。
Objective ： To compare the effectiveness and safety of bladder instillation of bzalkonium bromide （ BB）, pirarubicin （THP）, or mitomycin C （MMC） in prevention of postoperative recurrence of superficial bladder transient cell carcinoma（ SBTCC ）. Methods： One hundred and twenty-seven patients with SBTCC who underwent transurethral resection of bladder tumor （TURBt） or partial cystectomy were randomly divided into 3 groups. BB group （n = 43） received intravesical instillation of 0.1% BB 300 mL and retained for 15 rain for one time. THP group （n =42） received intravesical instillation of 30 mg THP in 50 mL of 0.9% NaCl solution. MMC group （n =42） received intravesical instillation of 40 mg MMC in 50 mL of 0.9% NaCl solution. THP and MMC were given to patients once a week for 8 weeks and then once a month for one year. All the patients were followed up and received cystoscopy examination. The recurrence rate and side effects were compared between the three groups. Results： All patients were followed up for 24 months. The tumor recurrent rates were 4.7% , 23.8% , and 26.2% in BB, THP, and MMC groups, respectively. The tumor recurrence rate of BB group was significantly lower than that in THP and MMC groups （ P 〈 0. 005 ）. The difference was not significant between THP and MMC group （ P 〉 0.05 ）. The pathological grade, clinical staging, primary and recurrent tumors, and different instillation drug therapies had significant effects on the recurence rate （ P 〈 0.05）. There was no statistical significance in the incidence rate of renal damage among the three groups （ P 〉 0.05 ）. Conclusion： Postoperative intravesical administration of BB is more effective than THP and MMC with well toleration and low cost. No apparent side effects are observed.
出处
《肿瘤》
CAS
CSCD
北大核心
2008年第12期1055-1058,共4页
Tumor
关键词
膀胱肿瘤
化学疗法
肿瘤
局部灌注
肿瘤复发
Bladder neoplasms
Chemotherapy, cancer, regional perfusion
Neoplasm recurrence
