吉西他滨与卡介苗灌注治疗高危非肌层浸润性膀胱癌的疗效对比分析

Efficacy comparison of intravesical instillation of gemcitabin and bacillus calmette guerin in patients with high-risk non-muscle invasive bladder cancer

目的比较卡介苗(BCG)与吉西他滨(GEM)膀胱灌注治疗高危非肌层浸润性膀胱癌(NMIBC)的疗效。方法选取2015年9月至2017年6月期间在本院208例行经尿道膀胱肿瘤切除术(TURBT)的高危NMIBC患者,分为GEM(GEM组,n=135)和BCG(BCG组,n=73)行膀胱灌注治疗。分别搜集其临床资料,并随访两组肿瘤术后复发、进展及不良反应情况。结果BCG组复发率低于GEM组复发率(38.5%vs.21.9%),差异有统计学意义(P=0.015);GEM组肿瘤进展率20.0%(27/135)与BCG组肿瘤进展率13.7%(10/73)比较无统计学意义(P=0.257);GEM组不良反应发生率低于BCG组(14.1%vs.27.4%),差异有统计学意义(P=0.019)。结论高危NMIBC术后采用BCG辅助性治疗在预防肿瘤复发方面疗效优于采用GEM,两者在预防肿瘤进展方面疗效无差异。BCG治疗较GEM治疗不良反应发生率较高。

Objective To compare clinical efficacy of intravesical instillation of gemcitabine(GEM) and bacillus calmette guerin(BCG) for high-risk non-muscle invasive bladder cancer(NMIBC). Methods From September 2015 to June 2017, clinical data of 208 NMIBC patients underwent transurethral resection of bladder tumor were prospective analyzed.All patients were assigned into GEM group(n=135)and BCG group(n=73). Recurrence, progression and side effects between two groups were followed up. Results Recurrence rate of BCG group was significantly lower than GEM group(38.5% vs.21.9%, P=0.015). However, there was no significant difference(P=0.257) in tumor progression between GEM (20.0%) group and BCG group (13.7%), and adverse effects of GEM was significantly lower than BCG group (14.1% vs.27.4%, P=0.019). Conclusions BCG is superior to GEM in preventing recurrence, but there is no significant difference in tumor progression, adverse effects of BCG is higher than GEM group.