表柔比星与羟喜树碱膀胱灌注预防肌层浸润性膀胱癌术后复发的临床疗效观察
发布时间:2018-04-16 00:40
本文选题:肌层浸润性膀胱癌 + 经尿道膀胱肿瘤电切术 ; 参考:《吉林大学》2014年硕士论文
【摘要】:目的:探讨表柔比星与羟喜树碱膀胱灌注在预防肌层浸润性胱癌行经尿道膀胱肿瘤电切术后复发的临床疗效及安全性。 方法:选取行经尿道膀胱肿瘤电切术(TUR-BT)的膀胱癌患者,根据术后病理与患者及患者家属的意愿选择符合要求的43例肌层浸润性膀胱癌患者,将43例患者随机分成两组,A组23例患者(表柔比星组),B组20例患者(羟喜树碱组),术后24小时内行表柔比星50mg(或者羟喜树碱40mg)+生理盐水20ml膀胱灌注化疗,1h后开放尿管,术后1周起采用原剂量行膀胱内灌注化疗。表柔比星灌注方案为1次/周,连续8周,然后1次/月×10次,共1年,羟喜树碱灌注化疗方案为1次/周,连续8周,然后1次/2周×8次,再行1次/月×18次,共2年。随访比较两组患者术后肿瘤复发及发生并发症情况。 结果:43例患者的治疗随访时间为13—44个月,肌层浸润性膀胱肿瘤患者应用表柔比星与羟喜树碱在比较1年内复发率各为13.0%,20.0%,2年内复发率各为34.8%,30.0%,均无统计学差异(P>0.05),两者在预防膀胱肿瘤复发中均无明显的优越性。 结论:肌层浸润性膀胱癌患者行经尿道膀胱肿瘤电切术后并长期规律膀胱灌注表柔比星或羟喜树碱治疗达到了较为满意的疗效,膀胱内灌表柔比星和羟喜树碱化疗药物安全性与临床耐受性良好,患者手术指征掌握恰当,并且术后注意密切随访与复查,可显著提高患者术后的生活质量。
[Abstract]:Objective: to investigate the clinical efficacy and safety of epirubicin and hydroxycamptothecin in preventing recurrence of myometrial invasive cystoma after transurethral resection of bladder tumor.Methods: patients with bladder cancer underwent transurethral resection of bladder tumor (TUR-BT). According to the postoperative pathology and the wishes of the patients and their families, 43 patients with myometrial invasive bladder cancer were selected.43 patients were randomly divided into two groups: group A (n = 23) (epirubicin group, n = 20), group B (n = 20) (hydroxycamptothecin group, n = 20). Within 24 hours after operation, 30 mg of epirubicin (or 40 mg of hydroxycamptothecin) were given intravesical infusion chemotherapy of epirubicin (50 mg) or hydroxycamptothecin (40 mg).Intravesical infusion chemotherapy was performed 1 week after operation.Epirubicin was given once a week for 8 weeks, then once a month 脳 10 times for a total of 1 year. Hydrocamptothecin infusion regimen was given once a week for 8 weeks, then 1 / 2 weeks 脳 8 times, and 1 / month 脳 18 times for 2 years.Tumor recurrence and complications were compared between the two groups.Results 43 patients were followed up for 13-44 months.The recurrence rates of epirubicin and hydroxycamptothecin in patients with intramuscular invasive bladder tumor were 13.0% 20.0 in 1 year and 30.0% in 2 years, respectively. There was no significant difference between them (P > 0.05). There was no obvious superiority in preventing the recurrence of bladder tumor between the two groups.Conclusion: after transurethral resection of bladder neoplasms and long-term regular bladder instillation of epirubicin or hydroxycamptothecin in patients with myometrial invasive bladder cancer, satisfactory results have been achieved.The safety and clinical tolerance of intravesical instillation of epirubicin and hydroxycamptothecin were good.
【学位授予单位】:吉林大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R737.14
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