Callispheres可载药微球经导管动脉化疗栓塞治疗膀胱癌的疗效及对血清肿瘤标志物和VEGF、bFGF水平的影响

Efficacy of Callispheres drug-loaded microspheres in the treatment of bladder cancer by transcatheter arterial chemoembolization and its effect on serum tumor markers and VEGF,bFGF levels

目的 探讨Callispheres可载药微球经导管动脉化疗栓塞治疗膀胱癌的疗效及对血清肿瘤标志物和血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平的影响。方法 前瞻性选取2020年1月至2023年7月于德阳市人民医院治疗的100例膀胱癌患者为研究对象。按照随机数字表法将患者分为对照组和观察组,每组各50例。对照组实施碘油经导管动脉化疗栓塞治疗,观察组实施Callispheres可载药微球经导管动脉化疗栓塞治疗。比较两组的临床疗效、无进展生存期(PFS),术前和术后6个月的血清肿瘤标志物[血清癌胚抗原、甲胎蛋白及可溶性细胞间黏附因子-1(sICAM-1)]、血管内皮细胞生长因子(VEGF)及碱性成纤维细胞生长因子(bFGF)水平,并记录两组治疗期间不良反应发生情况。结果 术后1个月,两组ORR及DCR比较,差异均无统计学意义(P>0.05);术后6个月,观察组ORR及DCR分别为56.00%、78.00%,均高于对照组(34.00%、58.00%),差异均有统计学意义(P<0.05)。观察组中位PFS为25.68个月,长于对照组(16.70个月),差异有统计学意义(P<0.05)。术后6个月,两组血清癌胚抗原、甲胎蛋白及sICAM-1水平均较术前降低,且观察组的血清癌胚抗原、甲胎蛋白及sICAM-1水平分别为(322.24±21.94) ng/mL、(1 428.55±189.24)μg/L、(506.51±20.82)μg/L,均低于对照组[(410.18±25.41) ng/mL、(1 694.73±215.82)μg/L、(561.25±23.36)μg/L],差异均有统计学意义(P<0.05)。术后6个月,两组VEGF、bFGF水平均较术前降低,且观察组的VEGF、bFGF水平分别为(202.61±37.71)、(3.19±1.01) pg/mL,均低于对照组[(239.75±42.48)、(4.63±1.42) pg/mL],差异均有统计学意义(P<0.05)。两组骨髓抑制、发热及疼痛等不良反应发生率比较,差异均无统计学意义(P>0.05);观察组不良反应化疗相关恶性、呕吐(CINV)分级优于对照组,差异有统计学意义(P<0.05)。结论 对膀胱癌患者实施Callispheres可载药微球经导管动脉化疗栓塞治疗可获得较好的临床疗效,且安全性相对较高,并能在一定程度上降低血清肿瘤标志物水平及血清VEGF、bFGF表达。

Objective To investigate the efficacy of Callispheres drug-loaded microspheres in the treatment of bladder cancer by transcatheter arterial chemoembolization and its effect on serum tumor markers and vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)levels.Methods A total of 100 patients with bladder cancer admitted to Deyang People's Hospital from January 2020 to July 2023 were prospectively selected as the research objects.The patients were divided into the control group and the observation group according to the random number table method,50 cases in each group.The control group was treated with lipiodol transcatheter arterial chemoembolization,while the observation group was treated with Callispheres drug-loaded microspheres transcatheter arterial chemoembolization.The clinical efficacy,progression-free survival(PFS),the levels of serum tumor markers[serum carcinoembryonic antigen,alpha-fetoprotein and soluble intercellular adhesion molecule-1(sICAM-1)],vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)before surgery and 6 months after surgery were compared between the two groups,and the incidence of adverse reactions during treatment was recorded.Results There was no significant difference in ORR and DCR between the two groups at 1 month after operation(P>0.05).At 6 months after operation,ORR and DCR in the observation group were 56.00%,78.00%,respectively,which were higher than those in the control group(34.00%,58.00%),the difference was statistically significant(P<0.05).The median PFS of the observation group was 25.68 months,which was higher than that in the control group(16.70 months),the difference was statistically significant(P<0.05).At 6 months after surgery,the levels of serum carcinoembryonic antigen,alpha fetoprotein,and sICAM-1 in two groups were lower than those before surgery,and the levels of serum carcinoembryonic antigen,alpha fetoprotein,and sICAM-1 in the observation group were(322.24±21.94)ng/mL,(1428.55±189.24)μg/L,(506.51±0.82)μg/L,respectively,which were lower than those in the control group[(410.18±25.41)ng/mL,(1694.73±215.82)μg/L,(561.25±23.36)μg/L],the differences were statistically significant(P<0.05).At 6 months after surgery,the levels of VEGF and bFGF in two groups were lower than those before surgery,and the levels of VEGF and bFGF in the observation group were(202.61±37.71)and(3.19±1.01)pg/mL,respectively,which were lower than those in the control group[(239.75±42.48)and(4.63±1.42)pg/mL],the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions such as bone marrow suppression,fever and pain between the two groups(P>0.05).The chemotherapy-induced nausea and vomiting(CINV)grade of adverse reactions in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).Conclusion Transcatheter arterial chemoembolization with Callispheres drug-loaded microspheres in patients with bladder cancer can achieve better clinical efficacy and relatively high safety,and can reduce serum tumor marker levels and serum VEGF and bFGF expression to a certain extent.