羟基喜树碱联合5-氟尿嘧啶于膀胱癌化疗中的疗效及安全性研究

The efficacy and safety of HCPT combined with 5-fluorouracil in treatment of bladder cancer

目的探讨羟基喜树碱联合5-氟尿嘧啶(5-Fu)在膀胱癌化疗中的疗效及安全性。方法选择2011年2月—2015年8月在我院诊治的晚期膀胱癌患者92例,根据随机数字表法分为观察组与对照组各46例,对照组给予5-Fu膀胱灌注化疗,观察组给予羟基喜树碱联合5-Fu膀胱灌注化疗,两组每周灌注1次,连续观察灌注3个月。结果观察组与对照组的化疗有效率分别为95.7%和76.1%,观察组明显高于对照组(P<0.05)。对照组和观察组化疗期间的膀胱刺激症状、血象异常、肝肾功能异常、骨髓抑制等不良反应状况没有统计学差异(P>0.05),所有不良反应在治疗后症状明显减轻。所有患者随访1年,观察组的死亡率与复发率分别为8.7%和4.3%,而对照组分别为30.4%和17.4%,观察组的死亡率与复发率都明显低于对照组(P<0.05)。结论羟基喜树碱联合5-Fu在膀胱癌化疗中具有强大的抗癌作用,且不增加不良反应的发生,能促进长期预后的改善,是一种安全、有效的膀胱局部化疗药物。

Objective To investigate the efficacy and safety of HCPT combined with 5-fluorouracil（5-Fu） in treatment of bladder cancer .Methods Selected 92 patients with advanced bladder cancer in our hospi-tal from February 2011 to August 2015 , equally divided into observation group and control group of 46 patients based on the random number table ,the control group were received 5-Fu intravesical chemotherapy ,The obser-vation group were given the HCPT combined with 5-Fu chemotherapy ,the chemotherapy infusion were once a week,continuous perfusion were observed for 3 months.Results The response rates in the observation group was 95.7%and the control group was 76.1%,the observation group were significantly higher than the control group （P〈0.05）.The occurrence of bladder irritation adverse reaction ,blood abnormalities,liver and kidney dysfunc-tion,bone marrow suppression in the observation group during chemotherapy compared with the control group were no significant difference（P〉0.05）,all adverse reactions after symptomatic treatment were improved .All patients were followed up for 1 year,The mortality and recurrence rates in the observation group were 8.7%and 4.3%re-spectively,while the control group were 30.4%and 17.4%,the mortality and recurrence rates of the observation group were significantly lower than the control group （P〈0.05）.Conclusion HCPT combined with 5 -Fu chemotherapy for bladder cancer has strong anti -cancer effect and without increase the incidence of adverse re-actions,it can promote the improvement of the long -term prognosis,so it is a safe and effective topical bladder chemotherapy drugs .