Intravesial Instillation Of Epirubicin For Preventing Postoperative Recurrence Of Superficial Bladder Cancer

Objective: An analysis was done to compare the prophylactic efficacy and treatment toxicity of intravesical therapy for primary superficial bladder cancer following TURBt on recurrence by HCPT versus EPI.Methods: 55 cases of primary superficial transitional bladder cancer were treated by TURBt.After surgical management, intravesical instillation therapy with HCPT or EPI was carried respectively. Follow up every 3 months, including cystoscopy and urinary, liver and kidney function. Record the local and systemic adverse reactions of medications at any time.55 patients were under continuous lumbar epidural anesthesia, using F26 Olympus plasma resectoscope transurethral resection of tumor. With 0.9% sodium chloride for flushing fluid, observe the location of tumor, particularly the relationship with the ureter, resect to the root of the tumor .Retent FOLEY's three-cavity catheter parallel bladder washout, indwelling catheter after 3-5 days .Perfuse in patients without hematuria . The epirubicin group of patients were perfused within 6 hours with epirubicin 50mg and normal saline solution by mixing 50ml poured through the bladder catheter and retain 30min, once a week, 8 times totally, then once a month , a total of 1 year; HCPT group of patients were perfused within 6 hours with saline 20ml plus HCPT 20mg, evenly mixed through the catheter poured into the bladder, and keep 120min, once a week , 8 times totally, then once a month , a total of 2 year.With telephone follow-up, the patient to were regularly reviewed. T test was used in disease-free interval between the two groups ,χ2 test was used in the recurrence rate and incidence of adverse to compare , withα= 0.05 used to determine significant community value.Results: 55 cases were followed up for 7~17 months. 3 cases of 21 patients treated by EPI relapsed at 3 months, 6 months and 10 months after surgery, 7 cases of 34 patients treated by HCPT relapsed at 3 months, 6 months, 9months, 12months and 15 months after surgery. Recurrence rate of EPI and HCPT group is 14.3% versus 20.6%.There is no significant difference between EPI and HCPT group in disease-free interval and recurrence rate. Treatment side effects rate between EPI and HCPT group is 14.7% versus 35.7%, mostly with low toxicity, which can be tolerance.Conclusions:(1) Intravesial instillation of epirubicin can prevent postoperative recurrence of superficial bladder cancer effectually.(2) Intravesial instillation of epirubicin has low toxicity.