吉西他滨与吡柔比星膀胱灌注预防非肌层浸润性膀胱癌术后复发的效果比较  

Comparison of efficacy between intra-bladder perfusion with gemcitabine and pirarubicin for preventing postoperative recurrence of non-muscle invasive bladder cancer

作　　者：张建军[1] 蔡维奇[1] 张绍崎[1] 方先林[1] 

机构地区：[1]江苏省南京鼓楼医院集团宿迁市人民医院暨徐州医学院附属宿迁医院泌尿外科,宿迁市223800

出　　处：《广西医学》2016年第9期1260-1262,共3页Guangxi Medical Journal

摘　　要：目的 对比吉西他滨与吡柔比星膀胱灌注预防非肌层浸润性膀胱癌（NMIBC）经尿道膀胱肿瘤电切术（TURBT）后复发的效果和安全性。方法 将行TURBT后的79例NMIBC患者随机分为吉西他滨组39例和吡柔比星组40例,于术后1周开始分别采用吉西他滨和吡柔比星规律膀胱灌注,比较两组的肿瘤复发率、无复发生存时间及化疗副作用发生情况。结果 随访12-32个月,吉西他滨组及吡柔比星组1年复发率分别为7.7%（3/39）、17.5%（7/40）,32个月累积复发率分别为12.8%（5/39）、25.0%（10/40）,两组1年复发率及累积复发率比较,差异无统计学意义（P〉0.05）。吉西他滨组及吡柔比星组患者的无复发生存时间分别为（29.57±1.03）个月和（21.31±4.70）个月,吉西他滨组无复发生存时间长于高于吡柔比星组（P〈0.05）。吉西他滨组膀胱刺激症状及血尿发生率低于吡柔比星组（P〈0.05）。结论 吉西他滨膀胱灌注预防NMIBC术后复发疗效满意,不良反应轻,值得临床应用。Objective To compare the efficacy and safety between intra-bladder perfusion with gemcitabine and pirarubicin for preventing the recurrence of non-muscle invasive bladder cancer after transurethral resection of bladder tumor（TURBT）. Methods Seventy-nine patients with non-muscle invasive bladder cancer after TURBT were randomly divided into gemcitabine group （n = 39） and pirarubicin group （n =40）. The gemcitabine group and pirarubicin group received regular intra-bladder perfusion with pirarubicin and gemcitabine after one week of TURBT respectively. The tumor recurrence rate, recurrence-free survival time and adverse reactions of chemotherapy were compared between the two groups. Results The patients received follow-up of 12 -32 months. The one-year recurrence rates of the gemcitabine group and piraurbicin group were 7.7% （3/39） and 17.5% （7/40） respectively,the 32-month cumulative recurrence rates of the gemcitabine group and pirantbicin group were 12.8% （5/39） and 25.0% （10/40） respectively. There was no statistical difference in the one-year recurrence rate or 32-month cumulative recurrence rate between the two groups（ P 〉 0. 05 ）. The recurrence-free survival times of the gemcitabine group and pirarubicin group were （29.57± 1.03 ） months and （21.31 ± 4.70） months respectively, and the time of the gemcitabine group was longer than that of the pirarubicin group（ P 〈 0.05 ）. The incidence rates of urinary disorders and hematuresis in the the gemcitabine group were lower than those in the pirarubicin group（ P 〈 0.05 ）. Conclusion Intra-bladder perfusion with gemcitabine can obtain a satisfied efficacy and has slight adverse reactions for preventing postoperative recurrence of non-muscle invasive bladder cancer, and is worthy of clinical application.

关 键 词：膀胱癌 吉西他滨 吡柔比星 膀胱灌注 经尿道膀胱肿瘤电切术 

分 类 号：R737.14[医药卫生—肿瘤]