Abstract: OBJECTIVE To compare the preventive and therapeutic effects of intravesical instillation of pirarubicin (THP) and hydroxycamptothecin (HCPT) on recurrence of bladder cancer.METHODS A comparative study of THP and HCPT intravesical instillation for the treatment of bladder cancer was performed and analyzed systematically.Relative risk (RR) and 95% confidence interval (CI) were used to evaluate the efficacy and toxicity differences.The statistical software was RevMan 5.3.RESULTS A total of 18 clinical studies included 1 597 patients,of which 822 received THP treatment,775 received HCPT treatment were analyzed.Meta-analysis showed that there was no significant difference in recurrence rate between THP group and HCPT group at 6 monthsRR=0.69,95% CI (0.47,1.02),P>0.05,and the recurrence rate was not statistically significant at 9 monthsRR=0.80,95% CI (0.42,1.54),P>0.05.The relapse rate in THP group was lower than that in HCPT group at one yearRR=0.74,95% CI (0.56,0.99),P<0.05,also lower than HCPT group at two yearsRR=0.74,95% CI (0.61,0.92),P<0.01.There was no significant difference between the two groups in the symptoms of bladder irritation and hemogram.There was significant difference in the incidence of urinary incontinence between the two groupsRR=1.74,95% CI (1.11,2 72)P=0.02.The incidence of hematuria in the HCPT group was lower than that in the THP group.CONCLUSION There is no significant difference in the recurrence rate between THP and HCPT for about 6 and 9 months after infusion.In the long term,the recurrence rate of THP in one year and two years is less than that in HCPT,while the incidence of hematuria in the HCPT group is lower than that in the THP group (P<0.05).THP is preferred in that it is resistant to adverse reactions.