吉西他滨联合顺铂治疗尿路上皮癌72例的临床研究

Clinical study of Gemcitabine and Cisplatin combination chemo- therapy in treatment of 72 cases of patients with urothelial cell carcinoma

目的探讨吉西他滨和顺铂的GC方案联合化疗治疗肌层浸润性尿路上皮癌的有效性和安全性。方法分析2010年9月-2012年9月于北京友谊医院接受静脉化疗的72例肌层浸润性尿路上皮癌患者的临床资料。其中男性47例，女性25例，平均年龄65（86—33）岁，所有患者均予以GC方案新辅助或术后辅助化疗（吉西他滨800～1000mg／m2第1、8、15天；顺铂70mg／m2第2天）。在完成1个周期化疗后开始复查CT评价疗效。结果72例患者中，完成2个周期及以上化疗的患者51例，共完成181个化疗周期。完全缓解（肿瘤消失）的患者10例，部分缓解27例，总体有效率为51．39％（37／72）。最常见的不良反应为恶心、呕吐和骨髓抑制，其次为肝、肾功能损害。结论GC方案治疗尿路上皮癌疗效确切，在密切随访和及时的辅助用药条件下，可以减少明显的不良反应，是治疗尿路上皮癌安全、有效的化疗方案。

Objective To explore the efficacy and safety of Gemcitabine and Cisplatin combination chemotherapy in treatment of muscle-invasive urothelial cell carcinoma. Methods Analyse of 72 cases of patients with muscle-invasive urothelial cell carcinoma receiving chemotherapy from September 2010 to September 2012, including 47 male and 25 female, the avarage age was 65 （86-33）. All patients were received GC chemotherapy （Gemcitabine 800-1 000 mg/m2, ivgtt, dl, d8, dlS; Cisplatin 70 mg/m2, ivgtt, d2）. Efficacy was reviewed after 1 cycle of chemotherapy. Results Fifty-one cases in all the patients completed two or more chemotherapy cycles and CR 10 cases, PR 27 cases, total effective rate was 51.39% （37/72）. The main toxic reactions included nausea, vomit, myelosuppression, and then damage of liver and renal function. Cconclusion GC regimen is a good choice for urothelial cell carcinoma. Close follow-up and the usage of adjuvant drugs can contribute to reduce the side effect of chemotherapy.