多柔比星灌注治疗对行TURBT术后浅表性膀胱癌患者临床疗效及相关指标的影响  

Effects of Doxorubicin Perfusion Therapy on Therapeutic Efficacy and Related Indexes in Patients with Superficial Bladder Cancer underwent TURBT

作　　者：王群[1] 胡卫红[2] 胡乃刚[1] 

机构地区：[1]平度市人民医院泌尿外科,山东平度266700 [2]平度市人民医院妇科,山东平度266700

出　　处：《中国药房》2017年第36期5091-5094,共4页China Pharmacy

摘　　要：目的:探讨多柔比星灌注治疗对行尿道膀胱肿瘤电切术(TURBT)的浅表性膀胱癌患者的疗效以及相关指标的影响。方法:回顾性分析96例浅表性膀胱癌患者的病历资料,按照用药不同分为观察组和对照组,每组48例。两组患者均常规行TURBT。在此基础上,观察组患者术后7 d给予含20 mg多柔比星的0.9%氯化钠溶液40 mL膀胱灌注治疗,对照组患者给予等量0.9%氯化钠溶液治疗,两组均连续治疗10个月,前8周每周1次,后每月1次。观察并比较两组患者复发率和疾病进展情况(缓解率、控制率、进展期生存率),治疗前后患者血清可溶性细胞间黏附分子1(sICAM-1)、可溶性血管细胞黏附分子1(sVCAM-1)和肿瘤标志物[重组人Dickkopf相关蛋白1(DKK1)和血管内皮生长因子(VEGF)]水平,同时记录患者不良反应发生情况。结果:治疗24个月后,观察组患者缓解率和控制率显著高于对照组,差异均有统计学意义(P<0.05);两组患者进展期生存率比较,差异无统计学意义(P>0.05)。治疗前,两组患者sICAM-1、sVCAM-1、DKK1和VEGF水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者sICAM-1、sVCAM-1、DKK1和VEGF水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者术后复发率和尿频/尿急、血尿、排尿困难发生率均显著低于对照组,差异均有统计学意义(P<0.05)。结论:多柔比星灌注治疗行TURBT后的浅表性膀胱癌患者,可以显著降低复发率,减轻肿瘤恶化程度,降低肿瘤活力,安全性亦较好。OBJECTIVE ： To investigate the effects of doxorubicin perfusion therapy on therapeutic efficacy and related indexes in patients with superficial bladder cancer underwent transurethral resection of bladder tumor （TURBT）. METHODS： Medical re- cords of 96 patients with superficial bladder cancer were analyzed retrospectively and divided into observation group and control group according to drug use, with 48 cases in each group. Observation group was given perfusion therapy of 0.9% Sodium choride solution 40 mL containing 20 mg doxorubicin 7 d after surgery. Control group was given TURBT combined with equal amount of 0.9% Sodium chloride solution. Both groups received treatment for consecutive 10 months, once a week in first 8 weeks, later once a month. The recurrence rate and disease progression of 2 groups were observed and compared, and the levels of slCAM-1 and sVCAM-1, the levels of tumor marker DKK1 and VEGF were observed before and after treatment. The occurrence of ADR was recorded. RESULTS： After 24 months of treatment, remission rate and control rate of observation group were significantly higher than control group, with statistical significance （P〈0.05）. There was no statistical significance in the progressive survival rate between 2 groups （P〉0.05）. Before treatment, there was no statistical significance in the levels of slCAM-1, sVCAM-1, DKK1 and VEGF between 2 groups （P〉0.05） ; after treatment, the levels of slCAM-I,sVCAM-1,DKK1 and VEGF in 2 groups were significantly lower than before treatment, the observation group was significantly lower than the control group, with statistical significance （P〈0.05）. The recurrence rate, the incidence of frequent/urgent urination, hematuria and dysuria in observation group after treatment were significantly lower than control group, with statistical significance （P〈0.0f）.CONCLUSIONS： For patients with superficial bladder cancer underwent TURBT, doxorubicin perfusion therapy can significantly reduce recurrence rate, relieve t

关 键 词：浅表性膀胱癌 多柔比星 肿瘤标志物 灌注治疗 尿道膀胱肿瘤电切术 可溶性细胞间黏附分子1 可溶性血管细胞黏附分子1 

分 类 号：R737.14[医药卫生—肿瘤]