Clinical Study On The Effect Of Thermotherapy With Rabdosia Liquid On Prevention Of Recurrence Of High-risk Non-muscular Invasive Bladder Cancer

ObjectiveTo explore the effectiveness and safety of the application of the thermotherapy with rabdosia liquid in the prevention of high-risk non-muscular invasive bladder cancer after bladder tumor surgery,and provide more evidence for the clinical treatment.Subjects and methodsRetrospectively analysis 90 cases with high-risk non-muscular invasive bladder cancer(NMIBC),who were underwent transurethral resection of bladder tumor(TURBt)or partial cystectomy,during January 2013-January 2006 in the first Affiliated Hospital of Zhengzhou university.All the cases were confirmed by the pathology of Urinary transitional cell carcinoma,pathological stage of non-muscle invasive carcinoma.The function of preoperative patients of heart,lung,liver,kidney and blood tests were no obvious abnormalities.The patients were divided into two groups on the basis of the opinion of the patients or their families : the rabdosialiquid group was consisted of 40 called group A.There were 30 males and 10 females aged 34-97 years,and the average age is 63.In group A there were Tis 3 cases,Ta 13 cases and T1 24 cases.The pathological grade,in accordance with WHO 2004 bladder urothelial carcinoma malignant grade grading system,included low-grade urothelial carcinoma 9 cases and high-grade urothelial carcinoma 31 cases.For 9cases the number of tumers was less than 3,and for the rest 31 cases that was not less than 3..The patients of group A were all treated with the thermotherapy with rabdosia liquid.Mitomycin infusion group was called group B with 40 cases,including 31 males and 9 females,aged 22-78 years,and the average age was 57.The postoperative pathological examination shown that there were Tis 3 cases,Ta 10 cases and T1 27 cases.The pathological grade included low-grade urothelial carcinoma 8cases and high-grade urothelial carcinoma 32 cases.For 14 cases the number of tumers was less than 3,and for the rest 26 cases that was not less than 3.All the cases in group B accepted the mitomycin intravesical chemotherapy.There was no significant difference in the clinical data and pathological results between the two groups(P> 0.05).The incidence of recurrence,progression and adverse reaction were observed in the two groups during the follow-up period to evaluate the clinical safety and efficacy of the method.ResultsThe follow-up time was 3-45 months.And the median follow-up time was 16 months.No cases exited the research due to serious adverse reactions.The recurrence rate was 32.5%(13/40)in group A and 55%(22/40)in group B.The recurrence rate was significantly different between the two groups(χ2 = 4.11,P = 0.043 <0.05).The recurrence rate of group A is significantly lower than that of group B.The rate of progress in group A was 17.5%(7/40),and the rate of progress in group B was 37.5%(15/40).There was also significant difference between the two groups(χ2 = 4.013,P= 0.045 <0.05).The rate of progress in group A was significantly lower.According to the distribution of recurrence time of bladder cancer,we use the Kaplan-Meier to analysis the no recurrence survival rate of the two groups.Finally the no recurrence survival time were 34 months in group A and 23 months in group B.A statistically significant difference was found between the two groups(log-rank test χ2 = 4.11,P =0.04 <0.05).The adverse reactions in the treatment are mainly cystitis(manifested as frequent urination,urgency,dysuria and other bladder irritation symptoms),gross and microscopic hematuria and bladder spasm pain.No serious complications appeared in the patients.The adverse reactions were found in 8 cases of group A and 10 cases of group B.The difference between the two groups was no significant(χ2 = 0.28,P>0.05).ConclusionThe thermotherapy with rabdosia liquid after bladder tumor surgeryan is an effective method to prevent recurrence of bladder tumor for patiens with high-risk non-muscular invasive bladder cancer.In compare with conventional perfusion chemotherapy,the thermotherapy with rabdosia liquid has has a lower recurrence rate and progress rate,and does not increase the incidence of adverse reactions.Therefore,it is considered that the application of the thermotherapy with rabdosia liquid in the prevention of high-risk non-muscular invasive bladder cancer after bladder tumor surgery is ideal for clinical treatment.