Kälble T, Beer M, Mendoza E, Ikinger U, Link M, Reichert H E, Frangenheim T, Klein E, Fabricius P G
Urologische Abteilung, Chirurgischen Universitäts-Klinik Heidelberg.
Urologe A. 1994 Mar;33(2):133-7.
A total of 78 patients with superficial bladder carcinoma were prospectively randomized to two groups following complete transurethral resection (TUR). Each received 12 intravesical instillations of 10(7) units interferon A or 120 mg BCG Connaught for 1 year starting 6 weeks post-TUR. After a mean observation period of 24 (13-31) months in the BCG and 25 (6-32) months in the IFN group 5/32 (15.6%) recurrences in the BCG versus 21/35 (60%) in the IFN group were observed (P = 0.0003). In the IFN group 18.4% of the patients had dysuria and 2.6% fever; in the BCG group 35% had fever, 60% cystitis, 1 patient granulomatous epididimoorchitis and 1 patient pneumonitis with granulomatous prostatitis. With our instillation regimen interferon A had few side effects but also no prophylactic effect, whereas BCG had tolerable-seldom severe--side effects and was very effective in preventing recurrences. Perhaps IFN should be given earlier after TUR and in a higher dosage.
78例浅表性膀胱癌患者在完全经尿道切除（TUR）后被前瞻性随机分为两组。每组在TUR术后6周开始接受12次膀胱内灌注，其中一组灌注10(7)单位的干扰素A，另一组灌注120mg诺康泰卡介苗，持续1年。卡介苗组平均观察期为24（13 - 31）个月，干扰素组为25（6 - 32）个月，观察到卡介苗组复发率为5/32（15.6%），干扰素组为21/35（60%）（P = 0.0003）。干扰素组18.4%的患者出现排尿困难，2.6%出现发热；卡介苗组35%出现发热，60%出现膀胱炎，1例出现肉芽肿性附睾炎，1例出现肺炎合并肉芽肿性前列腺炎。按照我们的灌注方案，干扰素A副作用少但无预防作用，而卡介苗副作用可耐受——很少严重——且预防复发非常有效。或许干扰素应在TUR术后更早给予且加大剂量。
