摘要
目的 评价表柔比星（EPI）与吉西他滨（GEM）交替序贯膀胱灌注辅助肿瘤切除术后化疗治疗非肌层浸润性膀胱癌的安全性及有效性.方法 将240例原发性非肌层浸润性膀胱尿路上皮癌患者按随机数字表法分为2组,每组120例,其中120例给予EPI 50 mg,1次/周,膀胱灌注（EPI组）,120例给予EPI 50 mg,隔周1次,GEM 1 000 mg,隔周1次,交替序贯灌注（EPI＋GEM组）.随访时间6～24个月,观察并记录肿瘤复发时间及化疗不良反应.结果 2年肿瘤无复发生存率EPI组为60.0％（72/120）,EPI＋GEM组为75.0％（90/120）,两组比较差异有统计学意义（x2=5.489,P＜0.05）.EPI组、EPI＋GEM组膀胱癌进展率分别为2.5％与1.7％,差异无统计学意义（x2=0.000,P＞0.05）.2组治疗主要不良反应为胃肠道不适（分别为15例与6例）,2组不良反应发生率分别为25.0％与11.7％,差异有统计学意义（x2=6.252,P＜0.05）.结论 对于非肌层浸润性膀胱尿路上皮癌使用EPI、GEM序贯膀胱灌注化疗较单用EPI具有较好的疗效,可降低术后2年复发率,能够降低不良反应的发生率,但不能改变膀胱癌的进展.
Objective To evaluate the safety and efficacy of epirnbicin （EPI） and gemcitabine （GEM） alternating sequential intravesical chemotherapy after transurethral resection in the treatment of non-muscle invasive bladder cancer. Methods 240 patients with primary non-muscle invasive bladder urothelial carcinoma were randomly divided into 2 groups. There were 120 cases for each group, EPI group was given EPI 50 mg （once a week）, bladder perfusion,while the EPI＋GEM group was given EPI 50 mg （once every other week）, GEM 1000 mg （once every other week）, alternating sequential perfusion. The follow-up time ranged from 6 to 24 months when the time of tumor recurrence and adverse reactions of chemotherapy were observed and recorded. Results The 2-year tumor free survival rate for EPI group recurrence was 60.0 % （72/120）, and 75.0 % （90/120） for EPI＋GEM group. There were statistical significance between the differences of the 2 groups （X2 = 5.489, P 〈 0.05）. 3 cases in EPI group and 2 cases in EPI＋GEM group progressed to muscle invasive bladder cancer, and there was no statistical significance between the differences of bladder cancer progression rates for the 2 groups （2.5 % and 1.7 %） （X2 = 0.000, P 〈 0.05）. The main adverse reaction during the treatment was gastrointestinal discomfort （15 eases and 6 cases respectively）, no serious haematological toxicity and other adverse reactions were frequent urination, urgency, dysuria and hematuria. The differences between the occurrence rates of adverse reactions for the 2 groups were 25.0 % and 11.7 %, which were statistically significant （x^2 = 6.252, P 〈 0.05）. Conclusion For non-muscle invasive urothelial bladder carcinoma, the curative effect is better to use EPI and GEM sequential intravesical chemotherapy than to use EPI alone, which can not only reduce the 2 years recurrence rate after the operation, but also reduce the incidence rate of adverse reactions. Yet, this method cannot change the progress of bladder cancer.
出处
《肿瘤研究与临床》
CAS
2014年第3期187-189,共3页
Cancer Research and Clinic
基金
辽宁省科技攻关项目（2013225220）
关键词
膀胱肿瘤
化学疗法
肿瘤
局部灌注
表柔比星
吉西他滨
Bladder neoplasms
Chemotherapy, cancer, regional perfusion
Epirubicin
Gemcitabine
