SUN Yang, MA Qiang, ZHENG Kewen, JU Hongge
Objective: To systematically evaluate the efficacy and adverse reactions of epirubicin (EPI) and mitomycin (MMC) in patients with non-muscle invasive bladder cancer (NMIBC) after perfusion chemotherapy. Methods: CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, The Cochrance Library and Web of science were searched for Chinese and English randomized controlled trials of epirubicin and mitomycin in the treatment of NMIBC from the establishment of the database to January 2023. RevMan 5.3 software was used to perform a meta-analysis of postoperative tumor recurrence rate, total incidence of adverse reactions, incidence of bladder irritation, liver and kidney function damage, and hematuria in the EPI group and the MMC group. Results: There were 16 studies that met the inclusion and exclusion criteria, with a total of 1244 patients, while 626 patients in the EPI group and 618 patients in the MMC group. The results of meta-analysis showed that the postoperative tumor recurrence rate [OR=0.55,95%CI(0.41, 0.73), P<0.01], the incidence of total adverse reactions [OR=0.56,95%CI(0.38, 0.82), P=0.003], the incidence of bladder irritation [OR=0.54, 95%CI(0.37, 0.77), P=0.0007], the incidence of hematuria [OR=0.53,95%CI(0.33, 0.85), P=0.009], and the incidence of liver and kidney dysfunction [OR=0.26, 95%CI(0.10, 0.69), P=0.007] in the EPI group were significantly lower than those in the MMC group (P<0.05). Conclusion: EPI is superior to MMC in terms of therapeutic effect and total incidence of adverse reactions. EPI bladder perfusion is recommended to prevent tumor recurrence and improve the prognosis of patients after bladder cancer surgery.