期刊文献+

不同剂量卡介苗膀胱灌注预防浅表性膀胱癌复发的效果 被引量:5

Effect of low dose bacillus Calmette-Guerin intravesical instillation against recurrence of superficial bladder cancer
下载PDF
导出
摘要 目的小剂量(40mg)卡介苗(BCG)膀胱灌注与常规剂量(120mg)膀胱灌注比较,评价其预防浅表性膀胱癌术后复发的疗效及其对并发症发生率的影响。方法随机将150例浅表性膀胱癌患者术后均分为三组。1组:常规剂量灌注组(BCG120mg);2组:半剂量灌注组(BCG60mg);3组:小剂量灌注组(BCG40mg)。术后1周开始BCG+生理盐水50mL膀胱内灌注,每周1次,6次后每月1次,术后每3个月行尿细胞学检查、膀胱镜活检等随访监测,比较各组间膀胱癌的复发率及灌注后并发症的发生率。结果随访12—30个月,平均20个月,1、2、3组膀胱癌的术后复发率分别为15.2%、14.3%、18.0%,2,3组分别与1组比较,差异无统计学意义(X2vs1^2=0.02,P〉0.05;(X3m1^2=0.13,P〉0.05)。1,2、3组膀胱灌注卡介苗后的并发症发生率分别为22%、10%、6%,3组的发生率显著低于1组(X^2=4.07,P〈0.05)。结论小剂量卡介苗膀胱灌注预防浅表性膀胱癌术后复发的效果等同于常规剂量,而灌注后并发症发生率显著减少,有较高临床应用价值。 Objective To explore the effect of low dose bacillus Calmette-Guerin(BCG) intravesical instillation in preventing superficial bladder transitional cell carcinoma(BTCC) recurrence and complications. Methods 150 patients with superficial BTCC who underwent transurethral resection of a bladder tumor or partial cystectomy were randomly divided into 3 groups: group 1 (50 cases) received a standard dose (120 mg) BCG treatment, group 2 (50 cases) received half a standard dose (60 mg) BCG, and group 3 received a low dose (40 mg) BCG. Each patient was given a regular instillation schedule: different doses of BCG plus 50 mL NS were instilled into bladders once a week, and after 6 weeks, the treatment was performed once a month. Urine cytology and cystoscopy were used to monitor the recurrence at 3-month intervals and the side effects of the BCG treatment were surveyed. Results At a median follow-up of 20 months (ranging from 12 to 30), the rates of tumor recurrence in groups 1, 2 and 3 were 15.2%, 14.3% and 18.0%. There was a no significant difference between group 1 and 2 (X2vs1^2 = 0.02, P 〉 0.05) or between group 1 and group 3 (X3ml^2 =0.13, P〉0.05). The rates of complications in groups 1, 2 and 3 were 22%, 10% and 6%. There was a significant difference between group 3 and 1 (X^2 = 4.07, P 〈 0.05). Conclusions Compared with standard dose intravesical BCG treatment, low dose BCG is similar in preventing superficial BTCC recurrence but is good in decreasing the comphcations.
出处 《山东大学学报(医学版)》 CAS 北大核心 2008年第5期513-515,519,共4页 Journal of Shandong University:Health Sciences
基金 山东省卫生厅科学研究基金资助项目(HZ045)
关键词 卡介苗 膀胱肿瘤 预防 Bacillus Calmette-Guerin Bladder neoplasms Carcinoma Prophylaxis
  • 相关文献

参考文献12

  • 1Koya M P, Simon M A, Soloway M S. Complications of intravesical therapy for urothelial cancer of the bladder[J]. J Urol, 2006, 175(6) :2004-2010.
  • 2Danisman A, Bulut K, Kukul E, et al. Urinary fibronectin levels in patients treated with intravesical bacillus Calmette- Guerin for superficial bladder cancer[J]. Urol Int, 2000, 64(4):198-201.
  • 3Saint F, Patard J J, Groux M B, et al. Evaluation of cellular tumour rejection mechanisms in the peritumoral bladder wall after Bacillus Calmette-Guerin treatment[J]. BJU Int, 2001, 88 (2):602-610.
  • 4Saint F, Patard J J, Maille P, et al. T helper 1/2 lymphocyte urinary cytokine profiles in responding and nonresponding patients after 1 an2 courses of bacillus Calmette-Guerin for superficial bladder cancer[J]. J Urol, 2001, 166(6):2142-2147.
  • 5Ponticiello A, Perna F, Maione S, et al. Analysis of local T lymphocyte subsets upon stimulation with intravesical BCG: a model to study tuberculosis immunity[J]. Respir Med, 2004, 98(6) : 509-514.
  • 6Suttmann H, Jacobsen M, Reiss K, et al. Mechanisms of bacillus Calmette-Guerin mediated natural killer cell activation [J]. J Urol, 2004, 172(4):1490-1495.
  • 7沈周俊,丁国庆,吴金艳,余燕岚,陆静,陈善闻,陈军.膀胱内灌注纤维蛋白溶解抑制药物对卡介苗抗膀胱癌复发作用影响的临床研究[J].中华泌尿外科杂志,2006,27(1):25-28. 被引量:6
  • 8O'Donnell M A, Lilli K, Leopold C, et al. Interim results from a national multicenter phase Ⅱ trial of combination bacillus Calmette-Guerin plus interferon alfa-2b for superficial bladder cancer[J]. J Urol, 2004, 172(3):888-893.
  • 9Zlotta A R, Van Vooren J P, Denis O, et al. What are the immunologically active components of bacille Calmette-Guerin in therapy of superficial bladder cancer? [ J ]. Int J Cancer, 2000, 87(6):844-852.
  • 10Kumar A, Dubey D, Bansal P, et al. Urinary interleukin-8 predicts the response of standard and low dose intravesical bacillus Calmette-Guerin(modified Danish 1331 strain) for superficial bladder cancer[J]. J Urol, 2002, 168(6) :2232- 2235.

二级参考文献9

  • 1Shen ZJ,Jin XD,Lu YL.Experimental study of fibronectin mediated drug resistance in chemotherapy for bladder cancer.Int J Uro1,2002,9(Suppl) :A33.
  • 2Lamm DL,Stogdill VD,Stogdill BJ,et al.Complication of bacillus Calmette-Guerin immunotherapy in 1,278 patients with bladder cancer.J Urol,1986,135:272-274.
  • 3Steg A,Leleu C,Debre B,et al.Systemic bacillus Calmette-Guerin infection in patients treated by intravesical BCG therapy for superficial bladder cancer.Prog Clin Biol Res,1989,310:325-334.
  • 4Ratliff TL,Palmer JO,McGarr JA,el al.Intraversical bacillus Calmette-Guerin therapy for murine bladder tumors:initiation of the response by fibronectin-mediated attachment of bacillus CametteGuerin.Cancer Res,1987,47:1762-1766.
  • 5Ratliff TL,Kavoussi LR,Catalona WJ.Role of fibronectin in intravesical BCG therapy for superficial bladder cancer.J Urol,1988,139:410-414.
  • 6Hudson MA,Yuan JJ,Catalona WJ,et al.Adverse impact of fibrin clot inhibitors on intravesical bacillus Calmette-Guerin therapy for superficial bladder tumors.J Urol,1990,144:1362-1364.
  • 7Hudson MA,Brown E J,Ritchey JK,et al.Modulation of fibronectinmediated Bacillus Calmette-Guerin attachment to murine bladder mucosa by drugs influencing the coagulation pathways.Cancer Res,1991,51:3726-3732.
  • 8沈周俊,丁国庆,陈昭典.增强卡介苗与膀胱壁结合力的实验研究[J].中华外科杂志,2001,39(12):951-953. 被引量:2
  • 9丁国庆,匡琳,沈周俊,陈昭典.膀胱内灌注纤维蛋白溶解抑制剂对卡介苗与膀胱壁结合力的影响[J].浙江医学,2002,24(6):337-339. 被引量:3

共引文献5

同被引文献38

引证文献5

二级引证文献18

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部