吉西他滨联合奈达铂与吉西他滨联合顺铂用于尿路上皮癌术后化疗的临床疗效和安全性比较

Comparison of clinical efficacy and safety of gemcitabine combined with nedaplatin or cisplatin in postoperative chemotherapy for urothelial carcinoma

目的分析比较吉西他滨联合奈达铂(GN)与吉西他滨联合顺铂(GC)化疗方案用于尿路上皮癌术后化疗的临床疗效和安全性。方法选取经病理检查证实的141例尿路上皮癌患者,分为2组,分别接受GN和GC化疗方案。GN方案:吉西他滨1000mg/m^2静脉输注,第1、8天;奈达铂80~100mg/m^2静脉输注,第1~3天。GC方案:吉西他滨1000mg/m^2静脉输注,第1、8天;顺铂25mg/m^2静脉输注,第1~3天。每3周为1个化疗周期,均至少连续性治疗3个周期后进行评估。结果141例患者随访6~36个月,2组在死亡率、2年无复发生存率、总复发率方面的差异均元统计学意义(P>0.05)。主要不良反应为血液学毒性和消化道反应,GN组白细胞减少和恶心呕吐的发生率均低于GC组,2组比较差异有统计学意义(P<0.05)。结论吉西他滨联合奈达铂方案与吉西他滨联合顺铂方案用于尿路上皮癌术后化疗的疗效相仿。而GN方案相关不良反应更小,值得推广使用。

Objective To explore the clinical efficacy and safety of gemcitabine combined with nedaplatin or cispla- tin in postoperative chemotherapy for urothelial carcinoma.Methods A total of 141 patients with urothelial carcinoma confirmed by pathological examination were divided into two groups and received GN (GN group,n =72)and GC (GC group,n =69)chemotherapy regimens respectively.GN regimen:intravenous infusion of gemcitabine 1000mg/m^2 on day 1 and 8 and intravenous infusion of nedaplatin 80-100mg/m^2 on day 1-3.GC regimen:1000mg/m^2 gerncitabine intravenous infusion on day 1and day 8 and intravenous infusion of cisplatin 25mg/m^2 on day 1-3.Treatments were repeated every 3 weeks as a chemotherapy cycle and all the patients were evaluated after at least 3 consecutive cycles of treatment,Results All the patients were followed up for 6 to 36 months.There were no significant differences in mortality,2-year recurrence -free survival rate and total recurrence rate between the two groups (P >0.05).The main adverse effects were hematological toxicity and digestive tract reaction.The incidence of leukopenia and nausea and vomiting in GN group was lower than that in GC group.The difference between the two groups was statistically significant (P <0. 05).Conclusions The efficacy of gemcitabine combined with nedaplatin is similar to that of gemcitabine combined with cisplatin.The GN regimen has less side effects and needs to be further promoted.