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目的评价经尿道膀胱肿瘤电切术(TURBt)联合吡柔比星(THP)膀胱内灌注预防浅表性膀胱癌复发的长期有效性。方法将64例浅表性膀胱癌患者TURB t术后分为两组,一组采用术后1周开始行吡柔比星膀胱灌注治疗,40 mg/次,每周1次共8次,以后每2周1次,共8次,以后每月1次持续到术后2年。对照组为术后拒绝进行吡柔比星膀胱灌注或灌注仅1～2次者。定期膀胱镜检查进行随访,观察其在1年、3年、5年、7年时的肿瘤复发率。结果随访60例患者,4例失访,随访时间18个月～11年,平均78个月。64例中坚持灌注治疗2年者49例,术后1年、3年、5年、7年时的肿瘤复发率分别为10.2%、16.3%、22.4%、34.7%;对照组15例,随访11例,术后1年、3年、5年、7年时的肿瘤复发率分别为36.4%、54.5%、63.6%、72.7%。维持灌注组首次复发时间平均为47个月,对照组平均复发时间为26个月。结论 TURB t术后膀胱灌注THP预防浅表性膀胱癌术后复发近期及远期疗效确切,患者耐受性好,可有效降低膀胱癌的近期及远期复发率,THP是较为理想的膀胱灌注化疗药物。
Objective To evaluate the long-term effectiveness of intravesical instillation of transurethral resection of bladder tumor (TURBt) combined with pirarubicin (THP) to prevent the recurrence of superficial bladder cancer. Methods Sixty-four patients with superficial bladder cancer were divided into two groups after TURB t. One group received intravesical instillation of pirarubicin at the first week after operation, 40 mg once daily for 8 times. Once every two weeks, a total of 8 times, once a month after the continued to 2 years after surgery. The control group refused to conduct piruettes than intravesical instillation or perfusion after surgery only 1 or 2 times. Regular cystoscopy was followed up to observe the tumor recurrence rates at 1 year, 3 years, 5 years and 7 years. Results Follow-up 60 patients, 4 patients were lost to follow-up for 18 months to 11 years, an average of 78 months. Among the 64 cases, 49 cases were treated with perfusion for 2 years. The recurrence rates at 1 year, 3 years, 5 years and 7 years after operation were 10.2%, 16.3%, 22.4% and 34.7% respectively. In the control group, 15 cases were followed up In 11 cases, the tumor recurrence rates were 36.4%, 54.5%, 63.6% and 72.7% at 1 year, 3 years, 5 years and 7 years respectively. The mean time to initial relapse in the maintenance perfusion group was 47 months, and the average recurrence time in the control group was 26 months. Conclusions TURB t after intravesical instillation of THP to prevent postoperative recurrence of superficial bladder cancer has definite curative effect in the short and long term. The patients are well tolerated and can effectively reduce the short-term and long-term recurrence of bladder cancer. THP is an ideal intravesical instillation Chemotherapy drugs.