吡柔比星、吉西他滨和顺铂联合治疗晚期膀胱癌的临床疗效分析

Clinical efficacy of pirarubicin and gemcitabine combined with cisplatin in the treatment of advanced bladder cancer

目的 分析吡柔比星、吉西他滨和顺铂联合治疗晚期膀胱癌的临床疗效及安全性。方法 120例晚期膀胱癌患者,按照治疗方案的不同分为对照组及观察组,每组60例。对照组患者采用吉西他滨联合顺铂静脉滴注治疗,观察组患者在对照组基础上联合吡柔比星热灌注治疗。比较两组患者的临床治疗效果、1年生存率、不良反应发生率及治疗前后尿液肿瘤相关因子[膀胱肿瘤抗原(BTA)、膀胱癌抗原核基质蛋白22(NMP22)、尿膀胱癌抗原(UBC)]水平。结果 治疗后,两组患者的BTA、NMP22、UBC水平均低于本组治疗前,且观察组患者的BTA(9.23±1.15)U/L、NMP22(19.11±2.32)U/ml、UBC(25.01±3.42)μg/L显著低于对照组的(12.01±1.26)U/L、(23.05±2.97)U/ml、(32.01±3.34)μg/L,差异有统计学意义(P<0.05)。观察组患者临床治疗总有效率为90.00%,高于对照组的71.67%,差异有统计学意义(P<0.05)。观察组1年生存率为83.33%(50/60),高于对照组的61.67%(37/60),差异有统计学意义(P<0.05)。观察组脱发、恶心呕吐、皮疹、乏力、粒细胞减少、血小板减少发生率分别为71.67%(43/60)、50.00%(30/60)、50.00%(30/60)、48.33%(29/60)、61.67%(37/60)、73.33%(44/60),与对照组的83.33%(50/60)、48.33%(29/60)、50.00%(30/60)、61.67%(37/60)、56.67%(34/60)、66.67%(40/60)比较,差异无统计学意义(P>0.05)。结论 吡柔比星、吉西他滨联合顺铂治疗晚期膀胱癌的临床效果显著,有利于延长患者生存时间,且不会增加不良反应发生率,安全性理想,值得临床推广应用。

Objective To analyze the clinical efficacy and safety of pirarubicin and gemcitabine combined with cisplatin in the treatment of advanced bladder cancer.Methods A total of 120 patients with advanced bladder cancer were divided into control group and observation group according to different treatment regiments,with 60 cases in each group.The control group was treated with intravenous drip of gemcitabine and cisplatin,and the observation group was treated with hyperthermic perfusion of pyirubicin on the basis of the control group.Both groups were compared in terms of clinical efficacy,1-year survival rate,incidence of adverse reactions and urinary tumor-related factors[bladder tumor antigen(BTA),nuclear matrix protein 22(NMP22),urinary bladder cancer antigen(UBC)]before and after treatment.Results After treatment,the levels of BTA,NMP22 and UBC in both groups were lower than those before treatment in this group;the observation group had BTA of(9.23±1.15)U/L,NMP22 of(19.11±2.32)U/ml and UBC of(25.01±3.42)μg/L,which were significantly lower than those of(12.01±1.26)U/L,(23.05±2.97)U/ml and(32.01±3.34)μg/L in the control group;the differences were statistically significant(P<0.05).The total effective rate of clinical treatment of the observation group was 90.00%,which was higher than that of 71.67%of the control group,and the difference was statistically significant(P<0.05).The 1-year survival rate of the observation group was 83.33%(50/60),which was higher than that of 61.67%(37/60)of the control group,and the difference was statistically significant(P<0.05).The incidence rates of alopecia,nausea and vomiting,rash,fatigue,granulocytopenia and thrombocytopenia of the observation group were 71.67%(43/60),50.00%(30/60),50.00%(30/60),48.33%(29/60),61.67%(37/60)and 73.33%(44/60),and those of the control group were 83.33%(50/60),48.33%(29/60),50.00%(30/60),61.67%(37/60),56.67%(34/60)and 66.67%(40/60),and the difference between the two groups was not statistically significant(P>0.05).Conclusion Pirarubicin and gemcitabine combined with cisplatin are effective in the treatment of advanced bladder cancer,which is beneficial to prolong the survival time of patients without increasing the incidence of adverse reactions and has an ideal safety,and is worthy of clinical promotion and application.