摘要
目的探讨吉西他滨与表柔比星序贯辅助治疗经尿道膀胱肿瘤切除术后非肌层浸润性膀胱癌的效果研究。方法选取2015年1月至2019年8月间杨凌示范区医院收治的78例非肌层浸润性膀胱癌患者,采用随机数表法分为研究组和对照组,每组39例。两组患者均行经尿道膀胱肿瘤切除术,术后1周内开始采用化疗药物治疗,对照组患者采用膀胱灌注表柔比星治疗,研究组患者采用吉西他滨与表柔比星序贯辅助治疗。比较两组患者治疗总有效率、术前与术后1年重组人Dickkopf相关蛋白1(DKK-1)和人类软骨糖蛋白39(YKL-40)变化、治疗不良反应及术后2年内复发情况。结果研究组患者治疗总有效率为84.6%,高于对照组的59.0%,差异有统计学意义(P<0.05)。术前,两组患者DKK-1和YKL-40指标比较,差异无统计学意义(P>0.05);术后1年,研究组患者DKK-1和YKL-40指标均低于对照组,差异均有统计学意义(均P<0.05)。研究组患者治疗期间不良反应发生率为10.3%,与对照组的12.8%比较,差异无统计学意义(P>0.05)。术后随访2年,研究组患者3例(7.7%)复发,对照组12例(30.8%)复发,差异有统计学意义(P<0.05)。结论吉西他滨与表柔比星序贯辅助治疗经尿道膀胱肿瘤切除术后非肌层浸润性膀胱癌患者疗效确切,可有效抑制肿瘤转移与侵袭,降低复发率,安全性较好,值得临床推广。
Objective To study the efficacy of sequential adjuvant therapy with gemcitabine and epirubicin in the treatment of non-muscle invasive bladder cancer after transurethral resection.Methods From January 2015 to August 2019,78 patients with non-muscle invasive bladder cancer who underwent transurethral resection of bladder tumors at Yangling Demonstration Area Hospital were selected as the study subjects.They were divided into a study group and a control group by random number table method with 39 patients in each group.The patients in both groups underwent transurethral resection of bladder tumor,and chemotherapy began within 1 week after the operation.The study group was treated with sequential adjuvant therapy with gemcitabine and epirubicin and the control group was treated with bladder irrigation with epirubicin.The overall efficacy,recombinant human Dickkopf related protein 1(DKK-1),human cartilage glycoprotein 39(YKL-40),treatment-associated adverse reactions and recurrence within 2 years were compared between the two groups.Results The overall efficacy rate was 84.6%in the study group which was higher than 59.0%of the control group(P<0.05).There was no significant difference in the levels of DKK-1 and YKL-40 between the two groups(P>0.05).At 1 year after the operation,the levels of DKK-1 and YKL-40 were lower in the study group than in the control group(all P<0.05).The incidence of adverse reactions was 10.3%in the study group and 12.8%in the control group during the treatment(P>0.05).After 2-year follow-up,the recurrence rate was 7.7%(3 patients)in the study group which was lower than 30.7%(12 patients)of the control group(P<0.05).Conclusion Sequential adjuvant therapy with gemcitabine and epirubicin is effective in the treatment of non-muscle invasive bladder cancer after transurethral resection.It can effectively inhibit tumor metastasis and invasion,reduce the recurrence rate with good safety,which is worthy of clinical promotion.
作者
孟涛
王纪科
刘锦波
黄鹏
杨钊
王运起
梁亮
邓骞
MENG Tao;WANG Ji-ke;IU Jin-bo;HUANG Peng;YANG Zhao;WANG Yun-qi;LIANG Liang;DENG Qian(Department of Urology Surgery,Yangling Demonstration Area Hospital,Xianyang 712100,China;Department of Urology Surgery,Shaanxi Provincial People's Hospital,Xi'an 710068,China)
出处
《中国肿瘤临床与康复》
2020年第6期738-741,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
陕西省自然科学基础研究计划项目(S2019-JC-YB-2374)。
关键词
膀胱肿瘤
吉西他滨
表柔比星
序贯治疗
经尿道膀胱肿瘤切除术
Bladder tumors
Gemcitabine
Epirubicin
Sequential therapy
Transurethral resection of bladder tumors
