Ba Mingchen, Cui Shuzhong, Wang Bin, Long Hui, Yan Zhaofei, Wang Shuai, Wu Yinbing, Gong Yuanfeng
Intracelom Hyperthermic Perfusion Therapy Center, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China.
Department of Urologic Oncology, Guangzhou Dermatology Institute, Guangzhou, Guangdong 510095, P.R. China.
Oncol Rep. 2017 May;37(5):2761-2770. doi: 10.3892/or.2017.5570. Epub 2017 Apr 11.
Preventing the recurrence of non-muscle invasive bladder cancer (NMIBC) post-transurethral resection (TUR) remains challenging. The aim of the present study was to investigate the effectiveness and safety of bladder intracavitary hyperthermic perfusion chemotherapy (BHPC) for prevention of NMIBC recurrence post-TUR. Between December 2006 and December 2014, 53 patients with NMIBC who underwent TUR were randomly assigned to receive BHPC (BHPC group, 28 patients) or intravesical chemotherapy alone (chemotherapy group, 25 patients) at the Intracelom Hyperthermic Perfusion Therapy Center of Guangzhou Medical University Cancer Hospital (Guangzhou, China). BHPC was performed by combining perfusion-based hyperthermia with chemotherapeutic agent mitomycin C (MMC) in the bladder, and the chemotherapy group of patients received bladder MMC perfusion. The concentration of MMC in the perfusion fluid and serum were assessed at different time-points. Tumor recurrence, disease-free survival (DFS), and side-effects were recorded and compared between the 2 groups. Results revealed that BHPC was performed smoothly, at ~44̊C in the bladder cavity. Patients tolerated BHPC, and no side-effects were observed. Both BHPC and intravesical chemotherapy achieved a high MMC concentration in the bladder perfusion liquid, but low MMC concentration in the serum, although serum MMC concentrations in the BHPC group were significantly higher (P<0.05). The tumor recurrence rate was significantly lower (10.7 vs. 28.0%; P=0.02) and the DFS period was significantly longer (37±1.2 vs. 19±0.9 months; P=0.001) in the BHPC group than in the chemotherapy group. Our results demonstrated that BHPC is safe and effective for preventing NMIBC recurrence post-TUR and prolongs DFS.
经尿道膀胱肿瘤电切术（TUR）后预防非肌层浸润性膀胱癌（NMIBC）复发仍然具有挑战性。本研究旨在探讨膀胱腔内热灌注化疗（BHPC）预防TUR后NMIBC复发的有效性和安全性。2006年12月至2014年12月期间，53例接受TUR的NMIBC患者被随机分配至广州医科大学附属肿瘤医院（中国广州）体腔热灌注治疗中心接受BHPC（BHPC组，28例患者）或单纯膀胱内化疗（化疗组，25例患者）。BHPC通过在膀胱内将基于灌注的热疗与化疗药物丝裂霉素C（MMC）联合进行，化疗组患者接受膀胱MMC灌注。在不同时间点评估灌注液和血清中MMC的浓度。记录并比较两组的肿瘤复发、无病生存期（DFS）和副作用。结果显示，BHPC在膀胱腔内约44℃时顺利进行。患者耐受BHPC，未观察到副作用。BHPC和膀胱内化疗均在膀胱灌注液中达到高MMC浓度，但血清中MMC浓度较低，尽管BHPC组的血清MMC浓度显著更高（P<0.05）。BHPC组的肿瘤复发率显著更低（10.7%对28.0%；P=0.02），DFS期显著更长（37±1.2对19±0.9个月；P=0.001）。我们的结果表明，BHPC在预防TUR后NMIBC复发方面安全有效，并延长了DFS。
