四种膀胱灌注方式在浅表性膀胱癌TUR-BT术后的疗效比较

发布时间：2018-04-09 14:09

本文选题：膀胱癌　切入点：膀胱灌注　出处：《新疆医科大学》2014年硕士论文

【摘要】：目的：比较吡柔比星(THP)单用疗法、羟基喜树碱(HCPT)单用疗法、THP与HCPT联合疗法及THP与HCPT交替疗法其四种膀胱灌注方法在浅表性膀胱癌术后治疗的疗效。方法：收集2002年5月至2010年5月来新疆医科大学第二附属医院和第五附属医院诊治的214例浅表性膀胱癌患者的临床资料,均行经尿道膀胱肿瘤切除术(TUR-BT),分成四组,术后均分别应用THP单用疗法、HCPT单用疗法、THP与HCPT联合疗法及交替疗法等四种膀胱灌注方法膀胱内灌注治疗,随访2年,观测四组在3个月、6个月、9个月、12个月、18个月、24个月时的肿瘤复发率及灌注期间的不良反应发生率。结果：比较术后3个月、6个月、9个月、12个月、18个月、24个月的复发率,THP+HCPT交替组与THP+HCPT联合组的术后复发率均低于THP单用组、HCPT单用组(P0.0127),THP+HCPT交替组的术后复发率稍低于THP+HCPT联合组(P0.0127),HCPT单用组稍低于THP单用组(P0.0127)。四组尿路刺激症状发生率分别为35.7%、32.7%、42.3%、15.7%,THP+HCPT交替组的尿路刺激症状发生率低于其余三组(P0.0127),其余三组尿路刺激症状发生率差异无统计学意义(P0.0127)。四组血尿发生率分别为20.8%、16.4%、26.9%、3.9%,THP+HCPT交替组的血尿发生率较其余三组低(P0.0127),其余三组血尿发生率差异无统计学意义(P0.0127)。四组肝、肾功能损害及血象异常发生率分别为10.7%、9.1%、15.4%、3.9%,THP+HCPT交替组肝、肾功能损害及血象异常发生率亦低于THP单用组、HCPT单用组和THP+HCPT联合组(0.0127)。结论：浅表膀胱癌在行TUR-BT后,膀胱内灌注THP+HCPT交替疗法与THP+HCPT联合疗法预防膀胱癌术后复发疗效确定,较THP单用疗法、HCPT单用疗法复发率低,且THP+HCPT交替疗法的毒副作用低于其他三种疗法,在临床上可能更具备一定的推广价值。
[Abstract]:Objective: to compare the efficacy of four bladder perfusion methods: pirarubicin (THP) alone, HCPT (hydroxy camptothecin) combined with HCPT and THP and HCPT in the postoperative treatment of superficial bladder cancer.Methods: the clinical data of 214 patients with superficial bladder cancer treated in the second affiliated Hospital and the Fifth affiliated Hospital of Xinjiang Medical University from May 2002 to May 2010 were collected. All patients underwent transurethral resection of bladder tumor and were divided into four groups.All the patients were treated with intravesical instillation of THP alone and HCPT combined with HCPT and alternating therapy respectively. The patients were followed up for 2 years.The recurrence rate of tumor and the incidence of adverse reactions during perfusion were observed at 3 months, 6 months, 9 months, 12 months, 18 months and 24 months in the four groups.The THP HCPT group was slightly lower than that of the THP group alone (P 0.0127).Conclusion: after TUR-BT is given to superficial bladder cancer, the curative effect of intravesical infusion of THP HCPT combined with THP HCPT in preventing recurrence of bladder cancer is determined, which is lower than that of THP alone.The toxicity and side effects of THP HCPT alternate therapy are lower than those of the other three therapies, which may be worth popularizing in clinic.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.14

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