【摘要】 背景与目的浅表性膀胱移行细胞癌术后易复发,本研究旨在探讨α-干扰素(interferon-alpha,IFN-α)联合吡柔比星灌注在降低浅表性膀胱癌术后复发方面的价值。方法应用重组人干扰素和吡柔比星(pirarubicin,THP)进行临床前瞻性试验研究。68例膀胱癌患者术后一周随机数字法分为两组(1)IFN-α+THP组33例,IFN-α3000万IU+THP40mg+5%GS40ml膀胱灌注;(2)THP组35例,THP40mg+5%GS40ml膀胱灌注。每周1次,连续8次,以后每月1次,共10次,12个月为一个疗程。结果随访期为6～32个月(中位随访期18.5个月),每3个月行膀胱镜检和组织活检一次。IFN-α+THP组33例患者中复发4例(12.1%),有4例出现膀胱刺激症状,3例有疲倦症状,1例出现皮疹。THP组复发8例(22.8%),有5例出现膀胱刺激症状,疲倦者3例,两组的不良反应发生率无显著性差异(P>0.05)。IFN-α+THP组比单用THP组有更好的疗效(P<0.05),尤其在预防G2、PT1膀胱肿瘤术后复发的效果优于单用THP组。结论IFN-α加THP灌注化疗对预防膀胱癌术后复发的疗效可能优于单用THP,但是其副作用情况以及是否适宜广泛使用还需作进一步的研究。更多还原

【Abstract】 BACKGROUND & OBJECTIVE: Superficial transitional cell carcinoma (TCC) of urinary bladder tends to recur after transurethral surgery. This study was designed to evaluate the effect of interferon alpha(IFN α)and pirarubicin(THP)on decreasing postoperative recurrence of superficial bladder cancer. METHODS: Recombinant IFN α and THP has been used in clinical study. One week After operation, 68 patients were prospectively enrolled and divided into two groups randomly: IFN α plus THP group and THP group. The protocols of chemoimmunoprophylaxis include 8 weekly and 10 monthly instillation of 3×107 IU IFN α plus 40 mg THP in 40 ml 5% glucose via catheter. RESULTS: The follow up period ranged from 6 to 32 months (median 18.2 months). The cytoscopy and cytology with cold cup biopsies had been carried out every 3 months for 2 years. Recurrence after instillation of IFN α combining THP was observed in only 4 cases (12.1%), bladder irritation was found in 4 cases, fatigue in 3 cases, and rash in 1 case as well. Among the 35 cases in THP group, recurrence was found in 8 cases (22.8%), bladder irritation in 5 cases, fatigue in 3 cases. IFN α plus THP yielded better effect than THP alone (P< 0.05),especially in grade 3 and stage PT1 bladder cancer. CONCLUSIONS: IFN α working in coordination with THP would be an effective remedy to prevent the recurrence of bladder cancer. The intravesical IFN α plus THP appears to be more effective against recurrence than THP alone. Further study is needed for side effect and popularization in such way.更多还原