膀胱肿瘤电切术后吉西他滨即刻膀胱灌注安全性及耐受性临床研究

The Clinical Study of the Safety and Tolerance of Using Gemcitabine in Bladder Perfusion Immediately after Transurethral Resection of Bladder Tumor

分析与评价膀胱肿瘤电切术（TUR-BT）后非肌层浸润性膀胱癌（NMIBC）盐酸吉西他滨（GEM）即刻膀胱灌注治疗的安全性及耐受性。将2013年1月~2015年7月期间在我院行TUR-BT的低级别非浸润性尿路上皮癌患者24例,采用随机方法分为A、B两组,每组各12例。A组患者术后给予1 200mg GEM即刻膀胱灌注,B组患者术后给予30mg吡柔比星（THP）即刻灌注。术后24h内膀胱灌注完成,观察1周。按抗癌药物急性及亚急性毒性反应分度标准,应用3个周期后两组24例患者的肾功、肝功均为0度。A、B两组不良反应为16.0%、25.0%,差异有统计学意义（P〈0.05）。不良反应主要表现为尿频、尿急、尿痛等,经对症治疗后缓解,未发生严重的血液学不良反应。故术后GEM即刻膀胱灌注化疗围手术期耐受良好,安全性高,未发现明显不良反应。

To investigate the safety and tolerability of using gemcitabine（GEM）for NMIBC of bladder perfusion immediately after transurethral resection of bladder tumor,data of 24 cases of low level of non invasive urothelial cancer underwent bladder tumor electricity cut（TURBT）retrospective from January 2013 to July 2015 in our hospital were analyzed in combination with literature.The patients were randomly divided into A and B two groups,each group had 12 cases.Group A was treated with 1200 mg GEM immediately after bladder instillation and B group was given 30 mg pirarubicin（THP）.We observed each group after 24 hof bladder instillation for one week.According to the standard of anticancer drugs acute and subacute toxicity reaction,two groups of renal function and liver function after application of three cycles both are zero.Analysis of the incidence of adverse reactions occurred in two groups of patients during perioperative period.The results of group A and B were separately 16% and 25%,the difference was statistically significant（P 〈0.05）.After symptomatic treatment,the adverse reactions mainly for frequent urination,urgency,dysuria,were relieved,none of serious hematologic adverse reactions happened.It is safety of using gemcitabine in bladder perfusion chemotherapy immediately after the transurethral resection of bladder tumor and no significant adverse reactions were found.However,we need to continuous studying the large sample clinical data.