吉西他滨与吡柔比星行膀胱灌注治疗膀胱癌的疗效比较

Comparison of the efficacy of gemcitabine and pirarubicin in the treatment of bladder cancer with intravesical instillation

目的比较吉西他滨与吡柔比星行膀胱灌注化疗经尿道膀胱肿瘤电切术(TURBT)非肌层浸润膀胱癌(NMIBC)的疗效。方法选取医院泌尿外科收治的行TURBT的NMIBC患者120例为研究对象,随机分为对照组和观察组,每组60例。对照组术后采用吡柔比星进行膀胱灌注化疗,观察组术后采用吉西他滨进行膀胱灌注化疗,随访2年。比较2组随访期间肿瘤复发率、首次复发时间、肿瘤进展率、进展时间和不良反应发生情况。结果观察组2年肿瘤复发率低于对照组,平均复发时间长于对照组(P <0. 05或P <0. 01);2组2年肿瘤进展率及平均进展时间比较,差异无统计学意义(P> 0. 05)。观察组膀胱刺激症状及血尿发生率低于对照组(P <0. 05);2组胃肠道症状、肝肾功损害及血液学毒性发生率比较,差异无统计学意义(P> 0. 05)。结论 NMIBC患者行TURBT术后使用吉西他滨进行膀胱灌注化疗效果显著,降低复发率,延长复发时间,不良反应较少,值得临床推广应用。

Objective To observe the efficacy of intravesical instillation chemotherapy with gemcitabine and pirarubicin in the treatment of transurethral resection of bladder tumor(TURBT)for non-muscle invasive bladder cancer(NMIBC).Methods One hundred and twenty patients with NMIBC who underwent TURBT in hospital urology were randomly divided into control group and observation group,with 60 cases in each group.In the control group,pirarubicin was used for intravesical instillation chemotherapy,and the observation group was treated with gemcitabine for intravesical chemotherapy.Both groups were followed up for 2 years.The tumor recurrence rate,the time of first recurrence,the rate of tumor progression,the time of progression,and the incidence of adverse reactions were compared between the two groups.Results The tumor recurrence rate of the observation group was lower than that of the control group in 2 years,and the average recurrence time was longer than that of the control group(P<0.05 or P<0.01).There was no significant difference in the 2-year tumor progression rate and mean progression time between the two groups(P>0.05).The incidence of bladder irritation and hematuria in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence of gastrointestinal symptoms,liver and kidney function damage and hematologic toxicity between the two groups(P>0.05).Conclusion Inpatients with NMIBC,gemcitabine was effective in intravesical chemotherapy after TURBT,which reduced the recurrence rate,prolonged the time of recurrence,and had fewer adverse reactions.It is worthy of clinical application.