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浅表性膀胱癌指的是肿瘤仅局限于膀胱粘膜和固有层,经尿道切除或开放性手术治疗后其3~5a复发率高达60%~90%,且往往6~12 mo内复发,而且10%~30%的患者,其复发肿瘤的分级分期加重。药物膀胱灌注治疗可减少肿瘤术后的复发率。现就几种常用的化疗药物和生物反应调节剂等疗法综述如下:1 化学疗法1.1 塞替哌(Thio-tepa,triethglen thiophospho-ramide,简称TSPA) TSPA属烷化剂类,具有直接破坏DNA并影响细胞分裂的作用,分子量为189(<200)。膀胱粘膜对其吸收量大,达33%~73%,可引起骨髓抑制(发生率为18%~40%),主要为白细胞减少和血少板减少,但并发药物性膀胱炎者少。治疗方法:膀膛灌注每次TSPA30~60 mg,初始时1次/w,膀胱保留2 h以上,共6~8次。膀胱手术切除不彻底者,可立即手术后对膀胱行TSPA灌注,70 y以上者不彻底
Superficial bladder cancer refers to the tumor is confined to the bladder mucosa and lamina propria, transurethral resection or open surgery after 3 ~ 5a recurrence rate as high as 60% to 90%, and often recur within 6 ~ 12 months, and 10% to 30% of patients, the recurrence of tumor grading staging. Drug bladder irrigation treatment can reduce the recurrence rate of tumor surgery. Here are several commonly used chemotherapy drugs and biological response modifiers and other therapies are summarized as follows: 1. Chemotherapy 1.1 Thio-tepa (Thio-tepa, TSPA) TSPA is an alkylating agent, with direct DNA damage Affect the role of cell division, the molecular weight of 189 (<200). Bladder mucosa absorption of its large, up to 33% to 73%, can cause bone marrow suppression (the incidence of 18% to 40%), mainly leukopenia and thrombocytopenia, but fewer concurrent drug cystitis. Treatment: Perfusion of TSPA per30 ~ 60 mg, initial 1 / w, bladder retention more than 2 h, a total of 6 to 8 times. Bladder surgery is not completely removed, the bladder can be immediately after surgery TSPA perfusion, more than 70 y is not complete