TURBT术前髂内动脉灌注吉西他滨和卡铂治疗T2、T3期肌层浸润性膀胱癌的疗效观察

Curative Effect of Internal Iliac Artery Perfusion of Gemcitabine and Carboplatin on Stage T2 and T3 Muscle-invasive Bladder Cancer before TURBT

目的观察经尿道膀胱肿瘤电切术(TURBT)术前髂内动脉灌注吉西他滨和卡铂治疗T2、T3期肌层浸润性膀胱癌(MIBC)的疗效。方法收集100例MIBC患者,按照就诊顺序编号随机分为单一组(TURBT术治疗,n=50)、联合组(TURBT术结合术前髂内动脉灌注吉西他滨和卡铂治疗,n=50),比较两组治疗疗效、治疗前后肿瘤直径大小、健康状况调查简表(SF-36)变化,观察两组并发症发生情况、随访复发率及生存率。结果联合组治疗的总有效率(82.00%)明显高于单一组(62.00%),与治疗前相较,治疗后两组肿瘤直径明显减小、SF-36评分明显升高,且联合组肿瘤直径明显小、SF-36评分高于单一组,两组并发症总发生率比较差异无统计学意义(P>0.05);但联合组术后1年随访复发率明显低于单一组(P<0.05);联合组术后2年无进展生存率明显高于单一组,平均无进展生存时间明显长于单一组(P<0.05),两组术后2年总生存时间和总生存率相较差异不显著(P>0.05)。结论TURBT术前髂内动脉灌注吉西他滨和卡铂治疗T2、T3期MIBC患者的临床疗效明显,在改善患者生活质量、降低复发率和提高无进展生存率等方面有积极作用。

Objective To observe curative effect of internal iliac artery perfusion of gemcitabine and carboplatin on stage T2 and T3 muscle-invasive bladder cancer(MIBC)before transurethral resection of bladder tumor(TURBT).Methods 100 patients with MIBC were selected and numbered according to the registration order.They were randomly divided into single group(TURBT,n=50)and combination group(TURBT combined with preoperative internal iliac artery perfusion of gemcitabine and carboplatin,n=50)according to visit order.The curative effect,changes in tumor diameter and short form 36 health survey(SF-36)before and after treatment were compared between the 2 groups.The occurrence of complications,recurrence rate and survival rate by follow-up in both groups were observed.Results The total response rate of treatment in combination group(82.00%)was significantly higher than that in single group(62.00%).After treatment,tumor diameter was significantly decreased,while SF-36 scores were significantly increased in both groups.The tumor diameter in combination group was significantly less than that in single group,while SF-36 scores were significantly higher than those in single group.There was no significant difference in total incidence of complications between the 2 groups(P>0.05).However,recurrence rate in combination group was significantly lower than that in single group 1 year after surgery by follow up(P<0.05).At 2 years after surgery,progression-free survival rate in combination group was significantly higher than that in single group,and mean progression-free survival time was significantly longer than that in single group(P<0.05).At 2 years after surgery,there was no significant difference in total survival time or overall survival rate between the two groups(P>0.05).Conclusion The clinical curative effect of internal iliac artery perfusion of gemcitabine and carboplatin is significant on stage T2 and T3 MIBC before TURBT,which plays positive effects in improving patients'quality of life,reducing recurrence rate and improving progression-free survival rate.