非肌层浸润性膀胱癌术后吉西他滨膀胱灌注化疗的疗效分析

Effect of intravesical chemotherapy for non-muscle-invasive bladder cancer treat with gemcitab

目的探讨非肌层浸润性膀胱癌患者术后应用吉西他滨膀胱灌注化疗的临床疗效。方法非肌层浸润性膀胱癌患者128例,均行经尿道膀胱肿瘤切除术(TURBT)。术后分别行吉西他滨(65例)和表柔比星(63例)膀胱灌注,随访2年,每3个月复查血尿常规、肝肾功能及膀胱镜检查,观察两组膀胱癌复发和不良反应情况。结果 2年内随访无患者死亡,吉西他滨组复发率为18.46%(12/65),不良反应发生率为12.31%(8/65);表柔比星组复发率为19.05%(12/63),不良反应发生率为31.75%(20/63),两组复发率比较差异无显著性(P>0.05),但吉西他滨组不良反应发生率明显低于表柔比星组(χ~2=6.54,P<0.05)。结论表柔比星和吉西他滨防膀胱癌术后复发效果相近,而吉西他滨膀胱灌注副反应更少,患者耐受性良好。

ObjectiveTo evaluate the efficacy and safety of intravesical instillation therapy with gemcitab for non-muscle-invasive bladder cancer.Methods A total of 128 patients with non-muscle-invasive bladder cancer were randomly divided into 2 groups after transurethral resection of bladder tumor （TURBT）：observation group （n=65, received intravesical instillation of gemcitab） and control group （n=63, received intravesical instillation of epirubicn）.During the follow-up of 2 years, patients received blood, urinary and cystoscopic evaluations every 3 months.The tumor relapse rate and side effects were evaluated.Results All patients survived after 2 years.The recurrence rate was 18.46 % （12/65） and 19.05% （12/63） respectively in the observation group and control group, and the difference had no statistical significance （P〉0.05）.Adverse reaction rate was 12.31% （8/65） and 31.75% （20/63） respectively in the observation group and control group, and the difference was statistically significant （χ2=6.54, P〈0.05）.ConclusionEpirubicn and gemcitab have similar effects on patients with bladder cancer, but gemcitab causes fewer adverse reactions and is better tolerated.