Preoperative and postoperative intravesical instillation versus alone postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer: a prospective randomized controlled trial
10.3760/cma.j.issn.1006-9801.2017.03.003
- VernacularTitle:术前及术后膀胱灌注与单纯术后膀胱灌注吡柔比星预防非肌层浸润性膀胱癌术后复发的前瞻性随机对照研究
- Author:
Bin WANG
;
Jiwen SONG
;
Huiqing CHEN
;
Jianwu LIU
;
Zhenguo MI
- Keywords:
Urinary bladder neoplasms;
Chemotherapy;
carcinoma;
regional perfusion;
Pirarubicin;
Recurrence
- From:
Cancer Research and Clinic
2017;29(3):155-159
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of preoperative and postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer (NMIBC). Methods From September 2012 to March 2014, 120 patients who were diagnosed as NMIBC and accepted trans-urethral resection of bladder tumor (TUR-Bt) were collected and randomly divided into two groups, including treatment group (60 cases) and control group (60 cases). 30 minutes before the operation, instillation of pirarubicin (40 mg) was performed in the treatment group, then pirarubicin perfusion was given within 24 h after operation, once a week for 8 weeks, and once a month for 10 months after operation. In control group, instillation of pirarubicin (40 mg) was given within 24 h after operation, and other treatments were the same as the treatment group. The differences of lesion detection probability, the 2-year recurrent rate and the adverse reaction rate were compared between the two groups. Results The lesion detection rates were 42.70 % (38/89) and 1.85 % (2/108) in the treatment group and control group, respectively (χ2=50.303, P<0.05). 119 patients were follow-up for 24 months. The 2-year recurrence rates were 8.47%(5/59), 21.67% (13/60) in treatment group and control group respectively (χ2= 4.033, P< 0.05). The adverse reactions mainly included hematuria (3 cases in treatment group, 3 cases in control group), urinary tract irritation (3 cases in treatment group, 2 cases in control group) and urethral stricture (1 case in treatment group, 1 case in control group). The difference of the adverse reaction incidence between the two groups was not significant statistically [11.86 % (7/59) vs. 10.00 (6/60), χ 2 = 0.106, P > 0.05]. Conclusions The preoperational intravesical instillation of pirarubicin can fix and diagnose malignant lesions in the bladder without adverse reactions, which will improve the rate of tumor resection and prevent postoperative recurrence of tumors.
