手术联合吉西他滨或吡柔比星膀胱灌注治疗老年膀胱癌的效果

A clinical comparative study of intravesical instillation of gemcitabine or pirarubicin in the treatment of bladder cancer in the elderly

目的对比分析手术联合吉西他滨或吡柔比星膀胱灌注治疗老年膀胱癌的临床效果。方法选取北京市隆福医院老年膀胱癌患者80例,以随机数字表法将患者分为两组,对照组40例,采用经尿道膀胱肿瘤电切术联合吡柔比星灌注治疗,观察组40例,采用经尿道膀胱肿瘤电切术联合吉西他滨灌注治疗,对两组的治疗效果进行比较。结果所有患者均进行为期2年的随访,观察组患者1年复发率、2年复发率均明显低于对照组,而2年生存率则均明显高于对照组(P<0.05);治疗后2年,比较两组患者生活质量(SF-36)、卡氏评分(KPS)均明显高于对照组(P<0.05);观察组患者的恶心呕吐、腹泻、膀胱炎、白细胞减少等不良反应明显低于对照组(P<0.05)。结论老年膀胱癌患者经尿道膀胱肿瘤电切术联合吉西他滨灌注治疗效果更为理想,且不良反应少。

Objective To compare and analyze the clinical effect of operation combined with gemcitabine or pirarubicinintravesical instillation in the treatment of senile bladder cancer.Methods A total of 80 elderly patients with bladder cancer in our hospital were selected and divided into two groups by envelope method.Forty patients in the control group were treated by transurethral resection combined with perfusion of pirarubicinand another 40 patients in the observation group were treated by transurethral resection combined with perfusion of gemcitabine.The therapeutic effects of the two groups were compared.Results All patients were followed up for 2 years.The 1-year recurrence rate and 2-year recurrence rate of the observation group were significantly lower than that of the control group,while the 2-year survival rate was significantly higher than that of the control group(P<0.05).Two years after treatment,the quality of life(SF-36)and KPS score(KPS)of the two groups were significantly higher than those of the control group(P<0.05).The adverse reactions of nausea and vomiting,diarrhea,cystitis and leucopenia in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Transurethral resection combined with gemcitabine infusion is more effective in treating bladder cancer in the elderly with fewer adverse reactions.