为了解卡介苗(BCG)与α-干扰素联合应用膀胱灌注预防膀胱癌术后复发的疗效,将72例膀胱癌随机分为两组:一组用BCG 75 mg+α-干扰素60万u,另一组单用BCG 75 mg膀胱内灌注。随访6~72个月,平均38.6个月,肿瘤复发者BCG+α-干扰素组2例(5.6%),BCG组9例(25%),两组比较有显著性差异(P<0.05)。结果表明:BCG与α-干扰素联合应用能更有效地预防膀胱癌术后复发。
Intravesical Instillation of BCG and Interferon Alfa for the Prevention of Postoperative Recurrence of Bladder Tumor
Ning Gang,et al;Department of Urology,Tianjin Third Hospital,Tianjin(300250)
Abstract For the prevention of tumor recurrence,intravesical instillation of 600 000 units of interferon alfa together with 75 mg of BCG were used for 36 postoperative cases of bladder cancer and intravesical instillation of 75 mg BCG along in another 36 for comparison.The formes group was follow-up 6~72 mouths,the average is 38.6 months and 2 of 36(5.6%) recurred.But 9 of 36(25%) recurred in latter group for the same period.BCG together with interferon alfa is recommended for intravesical instillation so as to reduce the postoperative recurrence rate of bladder cancer.
Key words Bladder cancer Intravesical instillation Recurrence
我院自1990年起联合应用BCG与α-干扰素膀胱内灌注预防膀胱癌术后复发,取得较好疗效,报告如下。
1 资料与方法
1.1 临床资料 膀胱癌72例,男64例,女8例。年龄25~76岁,平均61岁。初发肿瘤55例,复发17例;单发59例,多发13例。全组72例在灌注前行膀胱部分切除37例,TURBt 33例,激光切除2例。病理证实均为移行细胞癌。病理分级:Ⅰ级25例,Ⅱ级40例,Ⅲ级7例。临床分期:T0期7例,T1期56例,T2期9例。随机分为BCG+α-干扰素组和单用BCG组,每组36例。
1.2 治疗方法 BCG每支含75 mg活菌(由北京生物制品研究所提供),α-干扰素每支30万u(葛兰素威康公司生产)。术后2周开始膀胱灌注。BCG+α-干扰素组:BCG 75 mg+α-干扰素60万u+生理盐水至60 ml;BCG组:BCG 75 mg+生理盐水至60 ml。经导尿管注入膀胱,当药液即将注毕时,将阴茎尿管竖直注入少量空气,以防拔尿管时BCG残留于尿管内。灌注前4小时少饮水,灌注后每15分钟变换一次体位(左、右、仰、俯),保留2小时以后排出。每周灌注1次,共6次,此后1年内每月1次,1年后每2月1次至2年。 |