不同化疗方案治疗原发性膀胱癌术后患者生存期与生活质量的比较

Comparison of Postoperative Survival and Quality of Life among Primary Bladder Cancer Patients Received Different Chemotherapy Regimens

目的探讨不同化疗方案治疗原发性膀胱癌术后患者对其生存期与生活质量的影响。方法将符合纳入标准的116例原发性膀胱癌患者随机分为观察组、对照组,每组58例。观察组于术后行改良长期灌注化疗方案治疗,对照组于术后行短期灌注化疗方案治疗。灌注药物以50 ml蒸馏水稀释,排空膀胱后行药物灌注并保留,嘱患者15 min改变一次体位,60 min后自行排出。观察两组临床疗效、生存期、不良反应及生存质量改善情况。结果两组临床疗效比较,差异有统计学意义(P<0.05)。5年生存率观察组为48.3%,对照组为22.4%,两组比较差异有统计学意义(P<0.05)。两组治疗前生活质量评分比较差异无统计学意义(P>0.05);两组治疗后生活质量评分比较差异有统计学意义(P<0.05)。治疗过程中两组出现的毒副反应均以血液系统毒性、消化道反应为主。两组均出现白细胞减少、血小板减少、贫血、恶心呕吐、肝功能异常、肾功能异常、周围神经毒性、脱发等毒副反应,但对照组白细胞减少率、贫血再发生率、周围神经毒性发生率较观察组高,差异均有统计学意义(P<0.05)。结论改良长期灌注化疗方案可提高患者临床疗效及生活质量,延长患者生存期。

Objective To observe the postoperative survival and quality of life in patients with primary bladder cancer receiving different chemotherapy regimens.Methods A total of 116 patients who met the inclusion criteria were randomized into two groups（58 cases each）,with the observation group underwent a long-term postoperative infusion chemotherapy regimen and the control group underwent a short-term infusion chemotherapy.The drugs were diluted to 50 mL with distilled water and intravesical chemotherapy was performed after emptying the bladder with the drugs retained for 60 minutes.The patients were told to change the position every 15 minutes.Clinical efficacy,survival,adverse effects and quality of life improvement were compared between the two groups.Results Clinical efficacy between the two groups showed significant differences（P0.05）.Five-year survival rate was 48.3% for the observation group and 22.4% for the control group（P0.05）.Quality of life score between the both groups showed no significant differences（P0.05） before treatment;quality of life score between the both groups showed significant differences（P0.05） after treatment.Hematologic toxicity and gastrointestinal reactions,represented by leukopenia,thrombocytopenia,anemia,nausea,vomiting,liver dysfunction,renal dysfunction,peripheral nerve toxicity,and alopecia,were the main side effects for both groups.Incidence of leukopenia,anemia recurrence,and peripheral nerve toxicity were higher in the control group than the observation group（P0.05）.Conclusion The modified long-term infusion chemotherapy can improve the clinical efficacy,quality of life,as well as survival status of the patients.