膀胱癌术后吉西他滨与吡柔比星灌注对复发预防效果

EFFECT OF GEMCITABINE AND PIRARUBICIN BLADDER PERFUSION ON PREVENTION OF POSTOPERATIVE RECURRENCE OF BLADDER CANCER

目的探讨吉西他滨（GEM）与吡柔比星（THP）膀胱灌注预防膀胱癌术后复发的有效性及其安全性。方法 2012年1月—2013年3月,我院收治的浅表性膀胱癌病人79例,经尿道膀胱肿瘤电切术（TURBT）后,观察组39例病人采用GEM行膀胱灌注治疗,对照组40例病人采用THP进行膀胱灌注治疗。随访1~2年,观察两组复发情况及不良反应。结果观察组2年内复发率为17.9%,不良反应发生率为12.8%,对照组2年内复发率为22.5%,不良反应发生率为32.5%,两组复发率比较差异无显著性（P〉0.05）;观察组不良反应发生率明显低于对照组（χ~2=4.347,P〈0.05）。结论 GEM和THP预防膀胱癌术后复发效果相近,而GEM膀胱灌注不良反应更少,病人耐受性好,值得临床推广使用。

Objective To evaluate the efficacy and safety of intravesical Gemcitabine and Pirarubicin perfusion for preventing postoperative recurrence of baldder cancer. Methods From January 2012 to March 2013,79 patients with superficial bladder cancer were admitted to our department and treated with TURBT. After surgery,the patients were randomized to two groups as observation group（ n =39） and control group（ n = 40）. Patients in the observation group received intravesical Gemci-tabine irrigation,and those in the control group received Pirarubicin irrigation. A follow-up of 1- 2 years was conducted to observe their reccurence and adverse reactions. Results The recurrence rate was 17. 9%,and the incidence of adverse reactions was 12. 8%,within 2 years,in the observation group,and that in the control group was 22. 5% and 32. 5%,the difference in recurrence between the two groups was not significant（ P 〉 0. 05）,as for the incidence of adverse reactions,much lower was noted in the observation group（ χ~2= 4. 347,P 〈 0. 05）. Conclusion The efficacy of intravesical irrigation with Gemcitabine and Pirarubicin for preventing postoperative recurrence of baldder cancer is similar,but the adverse reactions are much less in Gemcitabine and well tolerated,which is worthy for extensive clinical application.