吉西他滨膀胱灌注治疗复发性非肌层浸润性膀胱癌的疗效分析

Efficacy of intravesical Gemcitabine for Epirubicin-refractory non-muscle invasive bladder cancer

目的评价吉西他滨膀胱灌注化疗治疗表柔比星膀胱灌注化疗后复发的非肌层浸润性膀胱癌(NMIBC)的有效性及安全性。方法回顾性分析52例经尿道膀胱肿瘤切除术后表柔比星灌注化疗后复发的NMIBC患者临床资料,其中23例灌注复发后行吉西他滨辅助灌注化疗,29例继续表柔比星灌注化疗。比较两组辅助性膀胱灌注后肿瘤无复发生存率、复发间隔时间、进展率以及不良反应。结果吉西他滨辅助性膀胱灌注患者的2年肿瘤无复发生存率达65.22%,显著高于表柔比星灌注组44.83%,两者比较差异具有统计学意义(P<0.05)。平均复发时间吉西他滨组[(15.87±3.36)月]明显长于表柔比星组[(10.06±3.04)月](P<0.05)。两组患者进展率和进展时间比较差异均无统计学意义(P>0.05)。两组不良反应发生率相当,主要表现为尿频、血尿、尿痛等,无严重不良反应。结论对于表柔比星辅助性膀胱灌注化疗后复发的NMIBC患者,给予吉西他滨辅助性膀胱灌注化疗疗效显著,能降低NMIBC复发率,延长无瘤生存时间,安全性较好。

Objective To evaluate the efficacy of Gemcitabine administered as an intravesical agent in patients with Epirubicin-refractory non-muscle invasive bladder cancer （NMIBC）. Methods Clinical data of 52 Epirubicin-refractory NMIBC patients were enrolled in this study. After transurethral bladder tumor resection, 23 patients received Oemcitabine and 29 received original intravesical chemotherapy. The 2-year tumor recurrence-free rate, time of first recurrence, and progression rate of the 2 groups of patients were compared. Treatment-related complications were evaluated. Results The 2-year tumor recurrence-free survival rate of the Gemcitabine group was higher than that of the Epirubicin group （66.22% vs. 44.83%, P〈 0.05）. The mean time of the first recurrence of Gemcitabine group was longer than that of Epirubicin group [（15.87 ±3.36） month vs. （10.06 ±3.04）month, P〈0. 05]. There was no statistically significant difference in tumor recurrence progression rate （P〉0.05）. Both intravesical administrations were generally well tolerated. The main adverse reactions were frequent urination, hematuria and dysuria. Conclusion Intravesical chemotherapy with Gemcitabine is well tolerated and effective for patients with Epiruhicin-refractory NMIBC.