吉西他滨与α-干扰素联合灌注化疗预防膀胱癌复发的临床研究

Clinical effect of intravesical instillation with GEM and recombinant human interferonα2b for prevention of postoperative recurrence of bladder tumor

目的：观察吉西他滨（GEM ）与α-干扰素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210例浅表性膀胱癌经尿道膀胱肿瘤电切术后患者分为两组：GEM＋α-干扰素联合应用组150例，术后立即用GEM 1000 mg灌注治疗，术后1周GEM 2000 mg再次灌注治疗，术后2～7周每周GEM和α-干扰素灌注治疗1次，以后每个月GEM 和α-干扰素灌注1次，持续2年；GEM组60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3～5年，其中GEM＋α-干扰素联合应用组复发率为11.3％，GEM 组复发率为23.3％，两组比较差异有统计学意义（ P＜0.05）。结论GEM和α-干扰素联合膀胱灌注化疗预防膀胱癌术后复发优于单用GEM灌注。

Objective To investigate the clinical effect of intravesical instillation with GEM and recombinant human interferonαfor prevention of postoperative recurrence of bladder tumor .Methods 210 patients with superficial bladder cancer were divid-ed into two groups .For the chemoimmunotherapy （GEM＋ recombinant human interferon α）group ,150 patients received post-operative intravesical instillation of GEM （1000 mg） immediately after transurethral resection of bladdertumor （TURBT） and again （2000 mg ）1 week later .From 2 to 7 weeks after TURBT ,GEM 1000 mg and recombinant human interferon α2 b was in-stilled into the bladder of all patients once weekly .Another 60 patients received postoperative intravesical instillation of 1000 mg once a week for 7 weeks .Then all patients received 2 travesical instillation every one month for 2 years .Results All patients had been followed up for 3 to 5 years .The recurrent rate was 11.3% in the test group and 23.3% in the GEM group .The effect was better in test group than in control group （P〈0.05） .Conclusion Intravesical instillation of GEM and recombinant human interferonαin turn were more effective in reducing postoperative recurrence rate of bladder tumor than GEM alone .