吉西他滨与卡介苗联合灌注预防膀胱癌复发的临床研究

Clinical Effect of Intravesical Instillation with GEM and BCG for Prevention of Postoperative Recurrence of Bladder Tumor

目的观察吉西他滨(GEM)与卡介苗(BCG)联合灌注免疫化学疗法预防浅表性膀胱癌术后复发的疗效。方法将85例浅表性膀胱癌经尿道肿瘤电切术后患者分为两组:(1)GEM+BCG联合应用组39例,术后立即用吉西他滨1000mg灌注治疗,术后1周GEM 2000mg再次灌注治疗,术后2～7周每周BCG灌注治疗1次,以后每个月BCG灌注1次,持续2年。每周行卡介苗灌注治疗。(2)BCG组46例,术后每周灌注1次,连续7次,以后每月1次,持续2年。结果随访2～3年,平均2年4个月,其中BCG+GEM联合应用组复发率为10.5%,BCG组复发率为24.2%,两组比较差异有显著性意义(P<0.05)。结论 GEM和BCG联合膀胱灌注预防治膀胱癌术后复发优于单用BCG灌注。

Objective To investigate the clinical effect of intravesical instillation with GEM and BCG for prevention of postoperative recurrence of bladder tumor. Methods 85 patients with superficial bladder cancer were divided into two groups. For the chemoimmunotherapy（GEM ＋ BCG）group, 39 patients as test group received postoperative intravesical instillation of GEM （1000mg） immediately after transurethral resection of bladder tumor（TURBT）and again （2000mg）1 week later. From 2 to 7 weeks after TURBT,BCG was instilled into the bladder of all patients once weekly. Another 46 patients received postoperative intravesical instillation of 120mg BCG once a week for 7 weeks. Then all patients received in 2 travesical instillation every one mon th for 2 years. Results All patients have been followed up for 2 to 3 years, with an average of 2 years and 4 months. The recurrent rate is 10.5% in the test group and 24.2% in the control group. The effect is better in test group than in control group （P〈0.05）. Conclusion Intravesical instillation of GEM and BCG in turn appears to be more effective for reducing postoperative recurrence rate of bladder tumor than BCG alone.