| Objective:For the clinical diagnosis and treatment of NMIBC provides high quality of the evidence,we compared the Intravesical Chemotherapy and chemohyperthermia of the advantages and disadvantages after non-muscle-invasive Bladder Cancer(NMIBC)operation and clinical effectiveness and safety of the two types of chemotherapy.MethodsBy computer retrieval the Cochrane library,MEDLINE(through PubMed retrieval platform),EMBASE(through the ovidsp retrieval platform),Chinese hownet(CNKI),Chinese biomedical literature database(CBM),WanFang database(WanFang),collecting intravesical Chemotherapy and chemohyperthermia in the treatment of bladder cancer clinical trials literature research,the retrieval time for libraries to October 15,2015.Manual retrieval associated literature of bladder tumor in several Chinese magazine,such as journal of modern genitourinary tumors,international journal of urinary system,the journal of urology,the journal of clinical urology,etc from 1993.1 to 2015.10.Two independent evaluators refered the new bias risk assessment tool which Cochrane Collabration recommends to evaluate the quality of literature.RevMan 5.3.0 recommended by Cochrane Collabration was employed for meta analyses.Results16 articles were included in this study,there are 8 included in this study articles after further eliminate data.In to 2 references for case-control study,belong to the retrospective test,the remaining six for randomized controlled trial(RCT),belongs to the prospective trials,including six papers in English and two in Chinese,included 455 patients.MMC chemohyperthermia group of 171 patients,MMC separate application group included 170 patients;Treat dose group of included 38 patients,prevent dose group included 46 patients.Compared to MMC alone group,chemohyperthermia MMC group's risk ratio was 0.17(95% CI,0.10,0.28);Dose treatment group compared with the recurrence of prevention dose group,the overall risk ratio was 0.66(95% CI,0.22,2.02);chemohyperthermia MMC group and chemotherapy alone MMC therapy group after treatment rate of disease progression,overall risk ratio was 0.62(95% CI,0.13 3.03);The incidence of bladder spasm in patients was 11.8%,the incidence of bladder pain was 12.9%;Bladder spasm were more likely to appear in the preventive treatment(17.8% vs 10.7%,p = 0.398),and the emergence of pain in the preventive and therapeutic plans basically the same,but more common in therapeutic plan(17.0% vs 15.6%,p = 0.366).And pain in the preventive and therapeutic plans of probability of basic same,compared with more common in therapeutic plan(17.0% vs 15.6%,p = 0.366).The risk of the meta analysis results bias degree is small,the result is more credible.ConclusionFrom our systematic Review,compared to intravesical chemotherapy,the probability of patient's recurrence rate after chemohyperthermia decreased 83.0%,the bladder overall survival rate reached 87.6%.There is no significant correlation between bladder preservation rate and drug dose.However,due to the limited number of randomized trials and different study design,also can't clear conclusion on its recurrence and progress.Compared to intravesical chemotherapy,the chemohyperthermia have more adverse reactions,but there was no statistically significant.Because the small number of system evaluation literature,there is a certain selection and publication bias,lack of large sample randomized controlled clinical trials support,so the above conclusion still need to be more in the future of large sample,multicenter,high quality clinical randomized controlled research for further validation. |
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