Tsushima T, Miyaji Y, Noda M, Nasu Y, Kumon H, Ohmori H
Department of Urology, Okayama University Medical School, Japan.
Urol Int. 1998;60(3):161-4. doi: 10.1159/000030242.
As postoperative adjuvant therapy for superficial bladder cancer, intravesical instillation therapy is commonly conducted. In this case, from the view point of prevention of intraoperative dissemination, commencement of instillation therapy at an early postoperative period is preferred. However, increased drug permeability is suspected because of damage to the bladder mucosa during operation. Therefore, this study was conducted to investigate the plasma level of epirubicin (EPI) instilled immediately after transurethral operation. EPI (20 mg/40 ml or 50 mg/100 ml) was instilled immediately after a transurethral operation, and retained in the bladder for 1 h. Blood samples were obtained before instillation, as well as 30, 60, 120 and 240 min after instillation, and EPI levels were assayed. The mean EPI concentrations (ng/ml) among the 20-mg/40 ml group (n = 5) were < 2.5 and < 2.0 at 30 and 60 min, respectively, after which they were undetectable. The 50-mg/100 ml group (n = 5) recorded 5.0, 4.4 and < 3.0 after 30, 60 and 120 min, respectively, and after 240 min it was undetectable. Intravesical instillation of EPI immediately after a transurethral operation causes a small increase in the plasma level and it is thought to cause small systemic side effects.
作为浅表性膀胱癌的术后辅助治疗，膀胱内灌注治疗是常用的方法。在这种情况下，从预防术中播散的角度来看，术后早期开始灌注治疗是较好的选择。然而，由于手术过程中膀胱黏膜受损，怀疑药物通透性会增加。因此，本研究旨在调查经尿道手术后立即灌注表柔比星（EPI）后的血浆水平。经尿道手术后立即灌注EPI（20mg/40ml或50mg/100ml），并在膀胱内保留1小时。在灌注前以及灌注后30、60、120和240分钟采集血样，并测定EPI水平。20mg/40ml组（n = 5）在灌注后30分钟和60分钟时的平均EPI浓度（ng/ml）分别<2.5和<2.0，之后检测不到。50mg/100ml组（n = 5）在灌注后30、60和120分钟时分别记录为5.0、4. and < 3.0，灌注后240分钟时检测不到。经尿道手术后立即膀胱内灌注EPI会使血浆水平略有升高，并且认为会引起轻微的全身副作用。
