Hexaminolevulinate Is Equal to 5-Aminolevulinic Acid Concerning Residual Tumor and Recurrence Rate Following Photodynamic Diagnostic Assisted Transurethral Resection of Bladder Tumors
Hexaminolevulinate Is Equal to 5-Aminolevulinic Acid Concerning Residual Tumor and Recurrence Rate Following Photodynamic Diagnostic Assisted Transurethral Resection of Bladder Tumors
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DOI：
10.1016/j.urology.2009.06.088
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发表时间：
2009-12-01
期刊：
影响因子：
2.1
通讯作者：
Denzinger, Stefan
中科院分区：
文献类型：
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作者：
Burger, Maximilian;Stief, Christian G.;Denzinger, Stefan
目的比较5-氨基乙酰丙酸（ALA）、六氨基乙酰丙酸（HEX）和白色光（WL）经尿道膀胱肿瘤切除术（TURB）的结局，以评估ALA结果与HEX的可转移性。通过光动力学诊断扩展WL-TURB可改善结局。两种荧光剂通常用于此。虽然有许多关于旧物质ALA的具体数据，但关于六氟乙烷的数据却少得多，而六氟乙烷是唯一获准使用的药物。方法采用随机发生器从我院资料库中随机抽取200例非肌层浸润性膀胱癌患者，分别行WL、ALA或HEX TURB。结果142例WL、139例ALA和135例HEX患者获得了完整的随访数据。中位随访时间为24个月。WL、ALA和hex的RT分别为33%、15%和9%。WL、ALA和hex的3年RFS分别为67%、80%和82%。ALA和HEX与WL相比RT显著降低（P <.001），RFS延长（P <.01）。ALA和HEX在RT和RFS方面分别无显著差异（RT：P =.37; RFS：P =.72）。结论在本回顾性系列中，ALA和HEX被发现显著优于WL。ALA和HEX之间没有差异。即使从仔细的角度来看，两种荧光剂似乎是相当的。因此，基于ALA的结果似乎可转移到获批药物HEX上。泌尿学74：1282 - 1288，2009。(C)2009 Elsevier Inc.
OBJECTIVES To compare the outcomes of 5-aminolaevulinic acid (ALA) vs hexaminolaevulinate (HEX) vs white light (WL) transurethral resection of bladder tumors (TURB) to assess transferability of ALA findings to HEX. Extending WL-TURB with photodynamic diagnostic improves outcome. Two fluorescent agents have been commonly used for this. Although numerous and specific data exist on the older substance ALA, considerably less are available on hex, the only agent approved however. To date no such report has been published.METHODS By random generator, each 200 patients with non-muscle-invasive bladder cancer having undergone TURB with WL, ALA or HEX were selected from our institutional data bank. Residual tumor in control TURB (RT) and recurrence-free survival (RFS) were assessed.RESULTS Complete follow-up data were available on 142 WL, 139 ALA, and 135 HEX patients. Median duration of follow-up was 24 months. RT was 33% in WL, 15% in ALA, and 9% in hex, respectively. RFS at 3 years was 67% in WL, 80% in ALA, and 82% in hex, respectively. RT was significantly reduced in ALA and HEX vs WL (P < .001) and RFS prolonged (P < .01). There were no significant differences between ALA and HEX in RT and RFS, respectively (RT: P = .37; RFS: P = .72).CONCLUSIONS In the present retrospective series, ALA and HEX were found to be significantly superior to WL. No differences between ALA and HEX were demonstrated. Even from a careful perspective both fluorescent agents seem to be comparable. Thus, ALA-based findings seem to be transferable on the approved agent HEX. UROLOGY 74: 1282-1288, 2009. (C) 2009 Elsevier Inc.