非肌层浸润性膀胱癌术后吉西他滨与表柔比星膀胱灌注化疗疗效及安全性分析

Comparison of the efficacy and safety between gemcitabine and epirubicin in intravesical instillation chemotherapy for non-muscle-invasive bladder cancer

目的探讨吉西他滨(GEM)与表柔比星(EPI)膀胱灌注预防非肌层浸润性膀胱癌术后复发的疗效及其安全性。方法 2015年6月至2016年6月收治的非肌层浸润性膀胱癌患者80例纳入研究,全部患者于经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)后随机分别予以GEM和EPI膀胱灌注治疗。随访1~2年,观察两组的复发情况及不良反应。结果 GEM组2年内复发率为20.0%,EPI组2年内复发率为22.5%,两组复发率比较差异无统计学意义(P>0.05);两组不良反应发生率分别为12.5%(GEM组)和32.5%(EPI组),GEM组不良反应发生率明显低于EPI组(χ~2=4.621,P<0.05)。结论 GEM和EPI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,患者耐受性好,值得临床推广应用。

Objective To compare the efficacy and safety between gemcitabine（GEM）and epirubicin（EPI）in intravesical instillation for preventing postoperative recurrence of non-muscle-invasive bladder cancer. Methods From June 2015 to June 2016,80 cases of non-muscle-invasive bladder cancer were treated with transurethral resection of bladder tumor（TURBT）,then GEM and EPI were used in intravesical instillation respectively.The recurrence of two groups and adverse reactions were observed during the follow-up period of one to two years. Results The recurrence rate was 20.0% in the GEM group and the recurrence rate was 22.5% in the EPI group.There was no significant difference in the recurrence rate between the two groups（P〉0.05）.The incidence of adverse reactions was 12.5% in the GEM group and the incidence of adverse reactions in the EPI group was 32.5%.The incidence of adverse reactions in GEM group was significantly lower than that in EPI group（χ^2=4.621,P〈0.05）. Conclusions GEM and EPI have similar effects on the prevention of recurrence of bladder cancer,while GEM has less adverse reactions.Thus,the patient is well tolerated with GEM,and it＇s worthy of clinical use.