高危險非肌肉侵犯性膀胱癌術後使用Miyomycin C膀胱灌藥的不同灌藥時間結果比較
陳宏睿、于大雄、吳勝堂
三軍總醫院 外科部 泌尿科
Comparison of different treatment schedules of mitomycin C intravesical instillation in high-risk superficial bladder cancer patients
Hong-Ray Chen, Dah-Shyong Yu, Seng-Tang Wu
Division of Urology, Departments of Surgery, Tri-Service General Hospital,
National Defense Medical Center, Taipei, Taiwan, Republic of China
Purpose: This study was performed to compare the efficacy of intravesical mitomycin C (MMC) instillation for the prophylaxis of Ta or T1 high-risk non muscle invasive bladder cancer (NMIBC) at different schedules.
Materials and Methods: his retrospective cohort study was conducted on 76 patients treated with intravesical MMC from Apr. 2009 to Sep. 2016. All of them received complete transurethral resection for bladder tumor (TURBT) and post operation installation of MMC within 24 hours. Patients were divided into four treatment groups. Group one were follow up without any maintain MMC dose treatment. Group two received MMC installation once per week for first 8 weeks. Group three received MMC installation once per week for first 8 weeks, and once per month for the following 6 months. Group four received MMC installation once per week for first 8 weeks, and once per month for the following 12 months.
Results: The overall recurrence rate was 27.6%. The group one had significantly high (p<0.05) recurrence rate of 50%, while there were no difference of recurrent rate between the last three schedules (group two 15%, group three 24.1%, group four 27.2%). Moreover, the recurrent rates of Ta or T1 tumor, low grade or high grade tumor, were not statistically different in these patients.
Conclusions: Our comparison of different schedules of intravesical MMC instillation showed obvious high recurrent rate at once MMC installation post-TURBT without maintain dose. The time of maintain MMC schedule made no different from eight weeks to twelve months. Thus, we tentatively conclude that for T1 or Ta high risk NMIBC, MMC installation should be done once after TURBT and maintain treatment once for 8 weeks.