低危膀胱癌患者术后采用吉西他滨联合吡柔比星膀胱灌注化疗的效果观察

Clinical effect of gemcitabine combined with pirarubicin intravesical chemotherapy for low-risk bladder cancer patients after operation

目的探讨低危膀胱癌患者尿道膀胱肿瘤电切术(TURBT)后应用吉西他滨联合吡柔比星膀胱灌注化疗的临床效果。方法抽取2019年4月至2020年4月于南阳市中心医院接受TURBT术的105例低危非肌层浸润性膀胱癌(NMIBC)患者纳入研究,随机将患者分为三组,分别为吉西他滨组、吡柔比星组和联合组,每组35例。吉西他滨组术后给予吉西他滨膀胱灌注,吡柔比星组术后给予吡柔比星膀胱灌注,联合组术后给予吉西他滨联合吡柔比星交替膀胱灌注。观察三组患者治疗结束后1个月的疗效和灌注期间不良反应发生情况。随访12个月,观察三组患者无复发生存情况。结果吉西他滨组缓解率(RR)和疾病控制率(DCR)高于吡柔比星组,灌注期间不良反应总发生率低于吡柔比星组,平均无复发生存期和中位无复发生存期长于吡柔比星组(P<0.05);联合组RR和DCR高于吉西他滨组,平均无复发生存期和中位无复发生存期长于吉西他滨组(P<0.05);联合组和吉西他滨组灌注期间不良反应总发生率比较差异未见统计学意义(P>0.05)。结论低危膀胱癌患者TURBT术后采用吉西他滨联合吡柔比星膀胱灌注化疗近期疗效好,可提高无复发生存率且安全可靠,可作为低危膀胱癌患者TURBT术后辅助治疗方案。

Objective To investigate the clinical effects of gemcitabine combined with pirarubicin intravesical chemotherapy for low-risk bladder cancer patients after transurethral resection of bladder tumor(TURBT).Methods A total of 105 patients with low risk non muscular invasive bladder cancer who underwent TURBT in Nanyang Central Hospital from April 2019 to April 2020 were enrolled.Patients were randomly divided into three groups:gemcitabine group,pirarubicin group and combination group,with 35 cases in each group.Gemcitabine group was given gemcitabine intravesical after surgery,pirarubicin group was given pirarubicin intravesical after surgery,and combined group was given gemcitabine and pirarubicin intravesical after surgery.The efficacy and adverse reactions of the three groups 1 month after treatment were observed.The relapse-free survival rate of three groups was observed during the 12 months of follow-up.Results Response rate(RR)and disease control rate(DCR)of gemcitabine group were higher than those of pirarubicin group,while the adverse reaction rate was lower than that of pirarubicin group(P<0.05).The mean and median relapse-free survival rate of gemcitabine group was higher than that of pirirubicin group(P<0.05).RR and DCR in combined group were higher than those in gemcitabine group,and the mean and median relapse-free survival rate was higher than that in gemcitabine group(P<0.05).The total incidence of adverse reactions had no significant difference between the combined group and gemcitabine group(P>0.05).Conclusions Application of gemcitabine combined with pirarubicin intravesical chemotherapy for low risk bladder cancer patients after TURBT is an effective and safe method to improve the relapse-free survival rate,which can be used as an adjuvant treatment regimen for patients with low-risk bladder cancer.