上尿路移行细胞癌术后预防性膀胱灌注的临床研究

摘要

Objective:To evaluate the efficacy of prophylactic intravesical chemotherapy for primary upper urinay tract urothelial cancer after nephroureterectomy.Methods:Sicty one patients with upper urinary tract urothelial cancer were included in this study.Patients were divided into two groups.One received intravesical epirubicin instillation,an-other did not receive phophylactic instillation after nephroureterectomy,compared the bladder tumor recurrence rate, time to first bladder tumor recurrence.Results:Significantly fewer patients who received epirubicin had a recurrence compared with the control group.Mean time to first bladder tumor recurrence was longer in epirubicen instillation group(P <0.05).Conclusion:Intravesical instillation of epirubicin is well tolerated and effective for preventing blad-der recurrence and prolonging time to recurrence.%目的：探讨上尿路移行细胞癌术后预防性膀胱灌注的有效性。方法：61例上尿路移行细胞癌患者行根治性切除术，其中34例患者术后预防性使用吡柔比星膀胱灌注，27例患者单纯随访，比较两组患者2年内膀胱肿瘤的发生率以及发生时间，并观察药物灌注毒副反应发生的情况。结果：吡柔比星灌注组膀胱癌发生率为14．7％，观察随访组膀胱癌的发生率为37．0％，差异有统计学意义（P ＜0．05），再发时间分别为20个月和14个月，二者比较差异有统计学意义（P ＜0．05）。患者灌注过程中均耐受，未出现中止灌注的情况。结论：本研究初步显示，吡柔比星预防性膀胱灌注可有效减少膀胱肿瘤的发生，毒副反应少，值得临床推广。