力尔凡辅助吉西他滨联合顺铂治疗晚期膀胱癌的疗效观察

The Clinical Observation of Lifein plus Gemcitabine and Cisplatine for Bladder Cancer

目的：探讨力尔凡辅助吉西他滨联合顺铂（ GC）治疗晚期膀胱尿路上皮癌的临床价值。方法膀胱尿路上皮癌患者83例，随机分为实验组（39例）和对照组（44例）。对照组单用GC化疗方案，吉西他滨1000 mg/m2，静脉滴注第1、8、15天；顺铂30 mg/m2，化疗第1～3天静脉滴注，28 d为1个疗程。实验组除给予GC方案化疗，并给予力尔凡辅助治疗。静脉滴注力尔凡20 mg＋生理盐水100 ml，每天1次，连用21天。对2组患者的临床疗效、KPS评分、不良反应等指标进行比较。结果对照组CR 5例（11．9％），PR 16例（38．1％），SD 13例（31．0％），PD 8例（19．0％）；实验组中CR 6例（15．4％），PR 20例（51．3％），SD 10例（25．6％），PD 3例（7．7％）。实验组总有效率（66．7％）虽比对照组（50．0％）提高，但是没有显著差异（P＝0．18）。实验组及对照组治疗前后KPS评分均没有显著差异，但是治疗2个周期后实验组KPS评分稳定及提高人数（34/39）比对照组（28/42）显著增加（P＝0．037）。实验组骨髓抑制比对照组较轻，其中Ⅲ～Ⅳ度白细胞降低发生率实验组显著降低（P＝0．006），且实验组周期推迟较对照组显著减少（P＝0．001）。结论力尔凡对膀胱尿路上皮癌具有一定治疗作用，而且能够保护骨髓，对减轻化疗的不良反应有一定作用，耐受性好。

Objective To evaluate the efficacy of Lifein combined with gemcitabine and cisplatine ( GC) chemotherapy for advanced bladder urothelial carcinoma carcinoma .Methods 83 patients with bladder urothelial carcinoma were randomly di-vided into experimental group (n=39)and control group(n=44).Patients in the control group were given GC chemotherapy:In-travenous drip of Gemcitabine 1 000 mg/m2 ,d1,d8 and d15;Cisplatine 30 mg/m2 ,d1~3.Patients in the control group were giv-en Lifein beside GC.Intravenous drip of Lifein 20 mg and saline 100 ml once a day for 21 days.The clinical efficacy,KPS,and side effects were observed in two groups.Results After two treatment cycles,there was 5 complete remission (11.9%),16 par-tial remission (38.1%),13 stable disease (31.0%) and 8 progression disease (19.0%) in the control group;and in the exper-imental group,there was 6 CR (15.4%),20 PR (51.3%),10 SD (25.6%) and 3 PD (7.7%).The overall rate of curative effect of experimental group(66.7%) was higher than that of control group (50.0%),but there was no significant difference .Pa-tients with increased KPS after treatment in the experimental group (34/39) were significantly more than those (28/42) of control group(P=0.037).There was less myelosuppression,Ⅲ~Ⅳ degree reduction of leukocyte(P=0.006) and deferred cycles in the experimental group(P=0.001).Conclusion Lifein has therapeutic effect on bladder urothelial carcinoma ,and can reduce myelosuppression and other side effects caused by chemotherapy .The combination of Lifein and GC is a promising treatment for advanced bladder urothelial carcinoma .