Hashimoto H, Yachiku S, Watabe Y, Niibori D, Yamauchi K, Osanai H, Ohashi K, Wakabayashi A, Fujisawa M
Dept. of Urology, Asahikawa Medical College.
Gan To Kagaku Ryoho. 1994 May;21(6):833-8.
Intravesical instillation of tetrahydropyranyl-adriamycin (THP) and cytosine arabinoside (CA) was performed on 42 patients with superficial bladder cancer after transurethral resection (TUR) for the purpose of prophylaxis of recurrence. The instillation was carried out with 30 mg of THP dissolved in 30 ml of distilled water and 200 mg of CA (total 40 ml). These drugs were instilled 7 times for the initial 2 weeks after TUR, and then 7 times every two weeks, 8 times every month, and 4 times every three months. Cases eligible for evaluation of efficacy were 38 out of 42 patients. The cumulative non-recurrence rate at one, two and three years were 94%, 84% and 75%, respectively. These high non-recurrence rates were demonstrated regardless of the size, number and pathological grade of the tumors. Severe bladder irritability was demonstrated in 8 (19%) of 42 patients, but generalized side effects were not seen in any case. The reformed regimen with 20 mg of THP in 30 ml of physiological saline solution was then performed on trial in several patients and there were no severe symptoms. THP combined with CA seems to be remarkably effective for the prophylaxis of recurrence, while a high concentration of THP in distilled water may lead to severe bladder irritability.
为预防复发，对42例经尿道膀胱肿瘤电切术（TUR）后的浅表性膀胱癌患者进行了膀胱内滴注四氢吡喃阿霉素（THP）和阿糖胞苷（CA）。将30mg THP溶解于30ml蒸馏水中，加入200mg CA（共40ml）进行滴注。这些药物在TUR后的最初2周内滴注7次，然后每2周滴注7次，每月滴注8次，每3个月滴注4次。42例患者中有38例符合疗效评估标准。1年、2年和3年的累积无复发率分别为94%、84%和75%。无论肿瘤的大小、数量和病理分级如何，均显示出较高的无复发率。42例患者中有8例（19%）出现严重膀胱刺激症状，但未发现任何全身性副作用。随后对几名患者试用了在30ml生理盐水中加入20mg THP的改良方案，未出现严重症状。THP联合CA似乎对预防复发非常有效，而蒸馏水中高浓度的THP可能导致严重的膀胱刺激症状。
