吉西他滨联合顺铂方案新辅助化疗联合全膀胱切除术治疗肌层浸润性膀胱癌的9年回顾性分析  

Gemcitabine plus cisplatin neoadjuvant chemotherapy with radical cystectomy for the treatment of muscle invasive bladder cancer： 9 years retrospective analysis

作　　者：曹明[1] 赵宏[1] 穆鑫[1] 金迪[1] 陈海戈[1] 薛蔚[1] 黄翼然[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,200125

出　　处：《中华泌尿外科杂志》2014年第1期49-53,共5页Chinese Journal of Urology

摘　　要：目的 评价吉西他滨联合顺铂（GC）方案新辅助化疗联合全膀胱切除术治疗肌层浸润性膀胱癌的疗效. 方法 回顾性分析2003年12月至2012年12月在我科完整接受2个疗程GC新辅助化疗联合全膀胱切除术的114例肌层浸润性膀胱癌患者为研究组,以2003年6月至2012年12月进行的120例单纯全膀胱切除术治疗的病例为对照组.两组性别、年龄、临床分期的比较差异均无统计学意义（P＞0.05）.比较两组的肿瘤局部控制及生存时间. 结果 研究组根治术后病理分期较原分期降低者76例,标本中无肿瘤残留27例,随访（51±25）个月,死亡43例,2年无复发生存率为75.9％,中位生存期79个月.对照组病理分期较原分期降低者23例,无肿瘤残留5例,随访（38±20）个月,死亡57例,2年无复发生存率为62.8％,中位生存期44个月.两组肿瘤降期率、无复发生存时间、总生存时间等比较差异均有统计学意义（P＜0.05）. 结论 GC方案新辅助化疗可以显著改善浸润性膀胱癌患者的预后,使肿瘤通过化疗降期,延长无瘤生存期及总生存期.Objective To assess the value of gemcitabine plus cisplatin （GC） neoadjuvant chemotherapy with radical cystectomy in the treatment of patients with muscle invasive bladder cancer （MIBC）.Methods The data of 114 patients with MIBC received GC neoadjuvant chemotherapy with radical cystectomy from December 2003 to December 2012 were retrospectively compared with those in other 120 patients treated with radical cystectomy alone from June 2003 to December 2012 in our institution.There was no significant difference of the gender,age and stage between the 2 groups （P＞0.05）.The duration of free survival,overall survival and the local control of tumor in different groups were compared.Results In the chemotherapy group,76 cases were found downstaging of the tumor after the operation,including 27 cases with tumor free.The mean duration of following up was （51 ±25） months.Forty-three patients died during the follow-up period.The median survival was 79 months and the 2-year recurrence free rate was 75.9％.In surgery alone group,23 cases were found downstaging of the tumor,including 5 cases with tumor free.The patients were followed up for （38±20） months.Fifty-seven patients died during the following up.The median survival was 44 months and the 2-year recurrence free rate was 62.8％.There were significant differences in downstaging rate of the tumor,recurrence free survival and overall survival between the 2 groups （P＜0.05）.Conclusion GC neoadjuvant chemotherapy can improve survival of the patients with MIBC,which facilitate to downstage the tumor and increase the recurrence free survival duration and overall survival duration.

关 键 词：膀胱肿瘤 肌层浸润性 抗肿瘤联合化疗方案 新辅助化疗 GC方案 

分 类 号：R737.14[医药卫生—肿瘤]