Deng Jian-Hua, Bai Jin-Liang, Zhang Shi-Sheng, Ma Peng-Cheng, Wan Jiang-Hou
Department of Urology, The First Affiliated Hospital of Lanzhou Medical College, Lanzhou, Gansu, 730000, P.R.China.
Ai Zheng. 2004 Jul;23(7):839-41.
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-alpha)and pirarubicin (THP) on decreasing postoperative recurrence of superficial bladder cancer.
Recombinant IFN-alpha and THP has been used in clinical study. One week After operation, 68 patients were prospectively enrolled and divided into two groups randomly: IFN-alpha plus THP group and THP group. The protocols of chemoimmunoprophylaxis include 8 weekly and 10 monthly instillation of 3 x 10(7) IU IFN-alpha plus 40 mg THP in 40 ml 5% glucose via catheter.
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-alpha 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-alpha plus THP yielded better effect than THP alone (P< 0.05),especially in grade 3 and stage PT1 bladder cancer.
IFN-alpha working in coordination with THP would be an effective remedy to prevent the recurrence of bladder cancer. The intravesical IFN-alpha plus THP appears to be more effective against recurrence than THP alone. Further study is needed for side-effect and popularization in such way.
膀胱浅表性移行细胞癌经尿道手术后易复发。本研究旨在评估α-干扰素(IFN-α)和吡柔比星(THP)对降低浅表性膀胱癌术后复发的效果。
重组IFN-α和THP已用于临床研究。术后1周,前瞻性纳入68例患者并随机分为两组:IFN-α联合THP组和THP组。化学免疫预防方案包括经导管每周8次、每月10次膀胱灌注3×10⁷IU IFN-α加40mg THP于40ml 5%葡萄糖中。
随访时间为6至32个月(中位时间18.2个月)。2年内每3个月进行膀胱镜检查及冷杯活检细胞学检查。IFN-α联合THP灌注后仅4例(12.1%)复发,4例出现膀胱刺激症状,3例出现疲劳,1例出现皮疹。THP组35例中,8例(22.8%)复发,5例出现膀胱刺激症状,3例出现疲劳。IFN-α联合THP的效果优于单用THP(P<0.05),尤其在3级和PT1期膀胱癌中。
IFN-α与THP协同作用是预防膀胱癌复发的有效疗法。膀胱内灌注IFN-α联合THP似乎比单用THP更有效地预防复发。需要进一步研究其副作用及推广应用方式。