目的 系統(tǒng)評價表柔比星（EPI）對比絲裂霉素（MMC）行膀胱灌注治療非肌層浸潤性膀胱癌（NMIBC）的療效和安全性。方法 計算機檢索PubMed、Cochrane Library、Ovid平臺生物醫(yī)學數(shù)據(jù)庫（OVID）、SpringerLink、中國期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）、維普生物醫(yī)學數(shù)據(jù)庫（VIP）及萬方數(shù)據(jù)庫中2000年1月1日—2023年2月1日發(fā)表的EPI（試驗組）與MMC（對照組）治療術后NMIBC的臨床隨機對照試驗（RCT），利用RevMan 5.3軟件進行Meta分析。結果 共納入14項RCTs，1 103例患者，其中試驗組553例、對照組550例。試驗組術后腫瘤復發(fā)率［OR＝0.52，95% CI（0.38，0.71），P<0.000 1］、膀胱刺激征發(fā)生率［OR＝0.51，95% CI（0.32，0.81），P＝0.004］、血尿發(fā)生率［OR＝0.47，95% CI（0.28，0.78），P＝0.004］均顯著低于對照組，但是兩種藥物行術后膀胱灌注的其他不良反應（肝腎損害、皮疹、惡心嘔吐、尿道狹窄）發(fā)生率比較，差異無統(tǒng)計學意義［OR＝0.67，95% CI（0.36，1.27），P＝0.22］。結論 使用EPI行膀胱灌注治療NMIBC患者的臨床療效略優(yōu)于MMC，但是仍需謹慎對待本次研究結果。

Objective To systematically evaluate the efficacy and safety of epirubicin (EPI) and mitomycin C (MMC) intravesical instillation in the treatment of non muscle invasive bladder cancer (NMIBC). Methods This research searched PubMed, the Cochrane Library, Ovid platform biomedical database (OVID), SpringerLink, CBM, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) of EPI (treatment group) and MMC (controll group) for the treatment of postoperative NMIBC published from January 1, 2000 to February 1, 2023. Meta-analysis was performed using RevMan 5.3 software. Results A total of 14 RCTs with 1 103 patients were included, including 553 in treatment group and 550 in controll group. The rates of recurrence[OR=0.52, 95%CI (0.38, 0.71), P < 0.000 1], bladder irritation sign[OR=0.51, 95%CI (0.32, 0.81), P＝0.004], and hematuria[OR=0.47, 95%CI (0.28, 0.78), P＝0.004] after bladder instillation with EPI were significantly lower than those treated with MMC instillation. However, there was no significant difference in the incidence of other adverse effects (hepatic and renal impairment, rash, nausea and vomiting, and urethral stricture) related to postoperative bladder perfusion between the two drugs[OR=0.67, 95%CI (0.36, 1.27), P＝0.22]. Conclusions Intravesical instillation with EPI showed slightly better clinical outcomes than MMC in patients with NMIBC, but the results of this study still need to be taken with caution.

R983，R979.1

河南省重點研發(fā)與推廣科技攻關專項（182102310059）；河南省高等學校重點科研項目（21A320015）；新鄉(xiāng)市科技攻關項目（GG2020032）；2020年度新鄉(xiāng)醫(yī)學院第一附屬醫(yī)院青年培育基金（QN-2020-A05）