摘要
目的探讨吉西他滨和吡柔比星膀胱灌注预防T1高级别膀胱癌经尿道电切术后复发的临床疗效差异。方法选取2010年1月—2015年12月本院收治的126例T1高级别膀胱癌患者,按随机数字表法分为吉西他滨组和吡柔比星组,每组各63例。吉西他滨组TURBT术后立即予以1 000 g吉西他滨+50 ml生理盐水行膀胱灌注,后续每周灌注化疗1次,治疗8次后,改为每月灌注化疗1次,共行灌注治疗2年。吡柔比星组术后立即予以30 mg吡柔比星+50 ml 5%葡萄糖溶液行膀胱灌注,后续每周灌注化疗1次,治疗8次后,改为每月灌注化疗1次,共行灌注治疗2年。观察两组患者术后肿瘤无复发生存时间、肿瘤进展时间、肿瘤进展率、肿瘤复发率和不良反应发生情况。结果吉西他滨组肿瘤复发率为30.16%,低于吡柔比星组(49.21%),(P=0.029)。吉西他滨组肿瘤无复发生存时间为(6.99±1.68)月,长于吡柔比星组:(4.54±1.55)月(P<0.05)。两组患者肿瘤进展时间、肿瘤进展率均无明显差异(P>0.05)。吉西他滨组不良反应总发生率与吡柔比星组无明显差异(P>0.05)。结论吉西他滨膀胱灌注化疗预防T1高级别膀胱癌TURBT术后肿瘤复发疗效优于吡柔比星,且不良反应发生率与吡柔比星相当。
Objective To investigate the clinical effect of gemcitabine and pirarubicin intravesical perfusion for preventing postoperative recurrence of T1 high grade bladder cancer after transurethral resection.Methods From January 2011 to December 2015,126 patients with T1 high grade bladder cancer were selected and classified into gemcitabine group and pirarubicin group by random number table method.Intravesical perfusion was performed immediately after TURBT in gemcitabine group with 1000 mg gemcitabine dissolve in 50 ml saline and in pirarubicin group with 30 mg pirarubicin dissolve in 50 ml glucose solution( 5%).Treatment was followed up once a week for a total of 8 times,which was changed to 1 time per month for a total of 2 years.The 2-year tumor recurrence rate,the recurrence free survival time of tumors,rate and time of tumor progression and adverse reactions were compared between the two groups.Results The recurrence rate of bladder tumor in the gemcitabine group was 30.16%,which was lower than that in the pirarubicin group( 49.21%).The recurrence free survival time of tumors in the gemcitabine group was( 6.99±1.68) months,longer than( 4.54±1.55) months in the pirarubicin group( P< 0.05).There was no significant difference in tumor progression rate and progression time between the two groups( P >0.05).There was no significant difference in the total rates of adverse reactions between the two groups( P>0.05).Conclusions The chemotherapy of intravesical perfusion with gemcitabine is effective to prevent postoperative recurrence in patients with T1 high grade bladder cancer.Moreover,adverse effect induced by gemcitabine was equal to pirarubicin.
作者
王德鑫
苗康
齐峰
袁宝
李超
刘一鸣
WANG De-xin(Beichen traditional Chinese hospital affiliated to Tianjin University of TCM,Tianjin,300400,China)
出处
《齐齐哈尔医学院学报》
2018年第19期2307-2309,共3页
Journal of Qiqihar Medical University
关键词
吉西他滨
膀胱肿瘤
经尿道膀胱肿瘤切除
膀胱灌注
Gemcitabine
Bladder tumor
Transurethral bladder tumor resection
Intravesical reperfusion
