1470nm半导体激光联合阿帕奇醌膀胱灌注治疗浅表性膀胱肿瘤的疗效评价

摘要

目的:探讨 1 470 nm半导体激光联合阿帕奇醌膀胱灌注治疗浅表性膀胱肿瘤的疗效.方法:将 112 例浅表性膀胱癌患者随机分为 1 470 nm半导体激光联合阿帕奇醌灌注方案组(阿帕奇醌灌注组)和 1 470 nm半导体激光联合吡柔比星方案组(吡柔比星灌注组),每组均为 5 6 例,阿帕奇醌灌注组激光术后 1 周联合阿帕奇醌膀胱灌注进行联合化疗,吡柔比星灌注组患者行激光联合吡柔比星灌注治疗,两组患者同时进行为期 12~36 个月的随访观察,分别对两组的肿瘤复发率、无瘤生存时间及不良反应发生情况进行比较.结果:阿帕奇醌膀胱灌注组和吡柔比星灌注组治疗方案的 1年复发率分别为 5.36% (3/56)、19.64% (11/56);36 个月累计复发率分别为8.93%(5/56)、26.79%(15/56),阿帕奇醌膀胱灌注组1 年复发率及3 6 个月累积复发率显著低于吡柔比星灌注组,差异有统计学意义(P<0.05).阿帕奇醌膀胱灌注组无复发生存时间(30.06±2.38)个月显著高于吡柔比星灌注组(23.42±4.05)个月(P<0.05).两组间不良反应比较差异无统计学意义(P>0.05).结论:与 1 470 nm 半导体激光联合吡柔比星灌注治疗相比,激光治疗联合阿帕奇醌膀胱灌注治疗浅表性膀胱肿瘤有更低的近期及远期复发率和更好的生存时间,同时不良反应易于耐受,是膀胱浅表性肿瘤的一种理想治疗手法,值得临床应用推广.%Objective:To analyze the clinical curative effect and side effects of 1 470 nm diode laser combined with intravesical chemotherapy of apaziquone for superficial bladder tumor.Methods:Fifty patients with superficial bladder tumor were randomly divided into a group of 1 470 nm diode laser combined with intravesical chemothera-py of apaziquone (combination group)and a group of 1 470 nm diode laser combined with intravesical chemothera-py of pirarubicin (control group).After treatment,the patients in two groups were followed up for 3 6 months, and the tumor recurrence rate,recurrence-free survival time and adverse reactions of chemotherapy were compared between the two groups.Results:The one-year recurrence rate in the combination group and control group was 5 . 36% (3/56)and 19.64% (11/56)respectively,and the 36-month cumulative recurrence rate in the combination group and control group was 8.93% (5/56)and 26.79% (15/56)respectively.The one-year recurrence rate and the 12-36 month cumulative recurrence rate in the combination group were significantly lower than those in the control group (P<0.05).No statistically significant difference was observed in side effects between the combina-tion group and control group (P>0.05).Conclusions:1 470 nm diode laser combined with intravesical chemother-apy of apaziquone for superficial bladder tumor is superior to 1 470 nm diode laser combined with pirarubicin.The apaziquone can decrease recurrence rate,at the meantime,the side effects are easily to be tolerated,and it is wor-thy of wide clinical application.