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榄香烯预防浅表性膀胱癌术后复发的临床观察

The effects of intravesical therapy with elemene in preventing postoperative recurrence of bladder cancer

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【作者】 李传刚刘用楫范治璐李荫田张智勇刘辉

【Author】 LI Chuan-gang,LIU Yong-ji,FAN Zhi-lu,et al.Second Affiliated Hospital of Dalian Medical University,Dalian 116023,China

【机构】 大连医科大学附属第二医院泌尿外科大连医科大学附属第二医院泌尿外科 116023116023

【摘要】 目的 观察榄香烯膀胱内灌注预防浅表性膀胱癌术后复发的疗效及毒副反应。 方法 膀胱癌术后患者123例,均为浅表性膀胱癌(T1 ),其中移行细胞癌Ⅰ级37例,Ⅱ级73例,Ⅲ级13例。随机分为2组,榄香烯治疗组63例,丝裂霉素对照组60例,分别采用榄香烯注射液及丝裂霉素C行膀胱内灌注,观察2组肿瘤复发情况、毒副反应及治疗前后血NK细胞活性。 结果 榄香烯组平均随访19. 7个月,复发5例,复发率7. 9%;灌注后出现膀胱刺激症状2例(3. 2% ),无严重血尿及尿道狭窄;患者治疗前血NK细胞活性为(20±2)%,治疗后为(28±2)%,治疗前后比较差异有统计学意义(P<0. 05)。丝裂霉素组平均随访19. 4个月,复发15例,复发率为25. 0%;灌注后出现膀胱刺激症状11例(18. 3% ),严重血尿3例(5. 0% ),尿道狭窄1例(1. 7% )。2组术后复发率、毒副反应发生率差异有统计学意义(P<0. 05)。 结论 榄香烯注射液膀胱灌注预防浅表性膀胱癌术后复发有良好疗效,毒副反应少,是一种值得推广的新方法。

【Abstract】 Objective To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects. Methods This series included 123 patients with superficial bladder cancer (T 1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment. Postoperatively, they were randomly assigned to 2 groups:63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC(40 mg,once a week) 2 weeks after operation. The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated. Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P<0.05).The side effect in elemene group(3.2%,2 cases) was significantly milder than that in MMC group (25.0%,15 cases)(P<0.05). In elemene group,the NK cell activity after treatment (28±2)% was significantly higher than that before treatment (20±2)% (P<0.05). Conclusions Instillation of elemene after operation is effective and safe in preventing postoperative recurrence of bladder cancer.

【关键词】 膀胱肿瘤榄香烯膀胱灌注复发
【Key words】 Bladder neoplasmsCarcinomaElemeneBladder instillationRecurrence
【基金】 大连市科委(96007);辽宁省教委(9804211039)资助
  • 【文献出处】 中华泌尿外科杂志 ,Chinese Journal of Urology , 编辑部邮箱 ,2005年04期
  • 【分类号】R737.14
  • 【被引频次】8
  • 【下载频次】131
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