吡柔比星与吉西他滨膀胱热灌注化疗对浅表性膀胱癌手术患者的疗效比较

Comparison of Efficacy of Pirubicin and Gemcitabine in Hyperthermic Intravesical Perfusion Chemotherapy in Patients Undergoing Surgery for Superficial Bladder Cancer

目的探究吡柔比星与吉西他滨膀胱热灌注化疗对浅表性膀胱癌手术患者的疗效及对血清肿瘤标志物水平的影响。方法选取2017年7月—2021年7月收治的114例浅表性膀胱癌为研究对象,按照治疗方式不同分为对照组和研究组,每组57例。2组均手术治疗,对照组采用吡柔比星膀胱热灌注化疗辅助,研究组采用吉西他滨膀胱热灌注化疗辅助,观察并对比近期治疗效果、血清肿瘤标志物[可溶性细胞间黏附分子-1(sICAM-1)、成纤维细胞生长因子(FGF)、血管内皮生长因子(VEGF)、癌胚抗原(CEA)]水平、安全性及生存指标[无进展生存期(PFS)、总生存期(OS)]。结果治疗后,研究组总有效率为80.70%(46/57)和疾病控制率为89.47%(51/57)均高于对照组[63.16%(36/57)和66.67%(38/57)](P<0.05)。治疗后,2组血清sICAM-1、FGF、VEGF、CEA水平较治疗前均降低,且研究组低于对照组(P<0.05)。研究组不良反应发生率为8.77%(5/57)和复发率为8.77%(5/57)低于对照组[24.56%(14/57)和29.82%(17/57)](P<0.05)。研究组PFS、OS均长于对照组(P<0.05)。结论浅表性膀胱癌手术患者术后采用吉西他滨膀胱热灌注化疗效果明显,能显著降低sICAM-1、FGF、VEGF、CEA水平,延长生存时间,且有较高安全性。

Objective To explore the effect of Pirarubicin and Gemcitabine in hyperthermic intravesical chemotherapy(HIVEC)on patients undergoing surgery for superficial bladder cancer and their impact on serum tumor markers.Methods In total,114 patients with superficial bladder cancer admitted from July 2017 to July 2021 were selected as the research subjects,and were divided into control group(n=57)and research group(n=57)according to different treatment methods.Both groups received surgical treatment,the control group received HIVEC supplemented with Pirarubicin,and the research group received HIVEC supplemented with Gemcitabine.The short-term therapeutic effect,serum tumor markers[soluble intercellular adhesion molecule-1(sICAM-1),fibroblast growth factor(FGF),vascular endothelial growth factor(VEGF),and carcinoembryonic antigen(CEA)]levels,safety and survival indicators[progression-free survival(PFS),overall survival(OS)]were observed and compared.Results After treatment,the total effective rate and disease control rate of the research group[80.70%(46/57)and 89.47%(51/57)]were higher than those of the control group[63.16%(36/57)and 66.67%(38/57)](P<0.05).After treatment,the serum levels of sICAM-1,FGF,VEGF,and CEA in both groups decreased compared with those before treatment,which were lower in the research group than in the control group(P<0.05).The incidence and recurrence rate of adverse reactions in the research group[8.77%(5/57)and 8.77%(5/57)]were lower than those in the control group[24.56%(14/57)and 29.82%(17/57)](P<0.05),and PFS and OS of the research group were longer than those of the control group(P<0.05).Conclusion Gemcitabine in HIVEC is effective in patients undergoing surgery for superficial bladder cancer,which can significantly reduce the levels of sICAM-1,FGF,VEGF,and CEA,prolong the survival time,and has high safety.