Clinical Efficacy Studies TURBT Intravesical Chemotherapy Drugs Commonly Used After Surgery To Prevent Cancer Recurrence

Objective Bladder cancer is the most common malignancy in the urinarydepartment. According to the degree of violation of cancer of the bladder wall,non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer(MIBC) are two main types in bladder cancer. Non-muscle invasive bladder cancer in aproportion of bladder cancer is about75%to85%, transurethral resection of bladdertumor (TURBT) is the main treatment, at the same bladder cancer tumor recurrence assignificant prognostic factors for postoperative patients. The most important way toprevent the recurrence of bladder cancer is intravesical chemotherapy given after surgery,but there is no uniform intravesical chemotherapy treatment. In our retrospective clinicalstudy,257NMIBC patients admitted in urology department of Shaanxi ProvincialPeople’s Hospital from January2008to March2012was collected in this study.Compared the efficacy and toxicity of regularly intravesical Pirarubicin、epirubicin andHCPT to prevent recurrence of non-muscle invasive bladder cancer. To observe therecurrence of transurethral resection of bladder tumor (TURBT) combined withintravesical three different chemotherapy drugs and offer a reliable reference for themedical therapy of patients with bladder cancer.Method257patients with non-muscle invasive bladder cancer were randomlydivided into two parts after TURBT surgery. Respectively given intravesicalchemotherapy after surgery and periodically reviewed and follow-up visited. At the sametime, we were closely monitored the complications and recurrence rate of patients atperiod of two years. The early part of intravesical (138patients): Ⅰgroup, within24h after TURBTsurgery given intravesical Pirarubicin (50patients); Ⅱgroup, within24h after TURBTsurgery given intravesical Epirubicin (41patients); Ⅲgroup within24h after TURBTsurgery given HCPT intravesical (47patients).Another part is the conventional intravesical (119patients): A group, after one weekgiven intravesical Pirarubicin (43patients); B group, after one week given intravesicalEpirubicin (39patients); C group, after one week given intravesical HCPT (37patients).Results(1)Early intravesical chemotherapy①Ⅰ group, Ⅱ group and Ⅲgroup respective recurrence rate were:8.00%,24.39%,25.53%; Ⅰ group with group Ⅱ, group Ⅰ and group Ⅲ showed statisticalsignificance (P<0.05), Ⅱ group and Ⅲ group was not statistically significant(P>0.05);②Three groups of blood, urine, liver function, kidney function were notsignificantly abnormal, no serious systemic adverse reactions.③Ⅰ group, Ⅱ group, Ⅲ group short-term bladder irritation rates were:24.00%,21.95%,23.40%, three groups was not statistically significant (P>0.05).④Ⅰ group, Ⅱ group, Ⅲgroup the incidence of hematuria were:12.00%,12.20%,12.77%, three groups was not statistically significant (P>0.05).(2)conventional intravesical①A group, group B, group C recurrence rate for two years, respectively:23.26%,46.15%,29.73%; A group and B group was statistically significant (P<0.05); A groupwith group C, group B and group C showed no statistical significance (P>0.05).②Three groups of blood, urine, liver function, kidney function were notsignificantly abnormal, no serious systemic adverse reactions.③A group, group B, group C short-term incidence of bladder irritation were:18.60%,17.95%,18.92%, three groups was not statistically significant (P>0.05).④A group, group B, group C, theincidence of hematuria are:9.30%,10.26%,8.11%, the three groups was not statistically significant (P>0.05). (3)Early intravesical and conventional intravesical①early and regular Pirarubicin intravesical instillation, the recurrence rate two yearsearlier with conventional intravesical instillation of epirubicin comparisons werestatistically significant (P<0.05), early and regular intravesical instillation of HCPTtwo-year recurrence rate was not statistically significant (P>0.05).②P irarubicin, epirubicin, early and regular bladder HCPT perfusion bladderirritation was no significant difference (P>0.05).③Pirarubicin, epirubicin, early and regular bladder perfusion hematuria HCPT caseno statistical significance (P>0.05).(4)The expenses of intravesical chemotherapyPirarubicin for per ampoule189yuan, once treatment require three ampoules.Epirubicin for per ampoule136yuan, once treatment spent three ampoules. However,HCPT for per ampoule145yuan, each intravesical treatment need two ampoules.Conclusion(1)The application of early intravesical Pirarubicin after transurethral resection ofbladder tumor can effectively and safely prevented the recurrence rate for postoperativeNMIBC patients, it is worthy of being popularized for anti-tumor therapy.(2)Comparison the efficacy of conventional intravesical chemotherapy with threedrugs for NMIBC patients, pirarubicin is better than Epirubicin, epirubicin and HCPThave the same efficacy.(3)There is not significant difference of toxicity and side-effects associated withintravesical chemotherapy. All patients are well-tolerated of this treatment.(4)HCPT is cheaper than other drugs, and it’s more suitable for clinical applicationin primary hospital. HCPT also help patients with financial difficulties to avoidinterruption of treatment.