吡柔比星联合羟基喜树碱膀胱灌注对老年浅表性膀胱肿瘤经尿道膀胱肿瘤电切术后患者复发风险、生存时间及血清学指标的影响

Effect of intravesical instillation with pirarubicin and hydroxycamptothecin on the risk of recurrence,survival time and serological indexes in elderly patients with superficial bladder canner after TURBT

目的:探讨吡柔比星联合羟基喜树碱膀胱灌注化疗对老年浅表性膀胱肿瘤(SBC)经尿道膀胱肿瘤电切(TURBT)术后患者复发风险、生存时间及血清学指标的影响。方法:将进行TURBT术的SBC患者126例随机分为两组。吡柔比星组采用吡柔比星膀胱灌注化疗。联合组采用吡柔比星联合羟基喜树碱膀胱灌注化疗。对比两组患者术后复发率、生存时间、近期疗效、血清学指标[可溶性细胞间黏附分子-1(sICAM-1)、E-钙粘素(E-cadherin)、肝细胞黏附分子(hepaCAM)、成纤维细胞生长因子(FGF)、基质金属蛋白酶(MMP)以及血管内皮生长因子(VEGF)]及不良反应发生情况。结果:术后48个月,联合组患者累计复发率低于吡柔比星组(P<0.05)。联合组患者1年生存率、2年生存率、无进展生存时间、总生存时间均高于吡柔比星组(均P<0.05)。联合组sICAM-1、FGF、MMP-2、MMP-9、VEGF水平均低于吡柔比星组,E-cadherin、hepaCAM水平均高于吡柔比星组(均P<0.05)。联合组总有效率、临床收益率均高于吡柔比星组(均P<0.05)。联合组不良反应总发生率低于吡柔比星组(P<0.05)。结论:吡柔比星联合羟基喜树碱膀胱灌注可降低患者复发率和不良反应发生率,提高近期疗效和生存时间。

Objective:To investigate the effect of intravesical instillation with pirarubicin and hydroxycamptothecin on the risk of recurrence,survival time and serological indexes in elderly patients with superficial bladder canner(SBC)after transurethral resection of bladder tumor(TURBT).Methods:126 SBC patients undergoing TURBT were randomly divided into two groups.The pirarubicin group was treated with intravesical instillation of pirarubicin.The combination group was treated with intravesical instillation of pirarubicin and hydroxycamptothecin.The postoperative recurrence rate,survival time,short-term curative effect,and serological indicators(sICAM-1,E-cadherin,hepaCAM,FGF,MMP and VEGF)and adverse reactions was compared between the two groups.Results:48 months after operation,the cumulative recurrence rate of the combination group was lower than that of pirarubicin group(P<0.05).The 1-year survival rate,2-year survival rate,progression-free survival time,and overall survival time of the combination group were higher than those of the pirarubicin group(all P<0.05).The levels of sICAM-1,FGF,MMP-2,MMP-9,and VEGF in the combination group were lower than those in the pirarubicin group,and the levels of E-cadherin and hepaCAM were higher than those in the pirarubicin group(all P<0.05).The total effective rate and clinical profit rate of the combination group were higher than those of the pirarubicin group(all P<0.05).The total incidence of adverse reactions in the combination group was lower than that in the pirarubicin group(P<0.05).Conclusion:Intravesical instillation of pirarubicin combined with hydroxycamptothecin can reduce the rate of recurrence and adverse reactions,and improve the short-term efficacy and survival time.