吉西他滨膀胱灌注化疗对非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术术后复发的影响  

Effect of intravesical chemotherapy with gemcitabine on the recurrence of nonmuscle-invasive bladder cancer patients after transurethral resection of bladder tumor

作　　者：程全科 王凯 朱向伟 CHENG Quanke;WANG Kai;ZHU Xiangwei(Department of Urology,Pingdingshan Medical District,No.989 Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army,Pingdingshan 467000,He’nan,China)

机构地区：[1]中国人民解放联勤保障部队第九八九医院平顶山医疗区泌尿外科,河南平顶山4670000

出　　处：《癌症进展》2021年第3期268-271,共4页Oncology Progress

摘　　要：目的探讨吉西他滨膀胱灌注化疗对非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤电切术(TURBT)术后复发的影响。方法依据膀胱灌注化疗药物将76例NMIBC患者分为研究组(n=42)和对照组(n=34),两组患者均接受TURBT术,术后研究组患者接受吉西他滨灌注化疗,对照组患者接受吡柔比星灌注化疗。比较两组患者膀胱灌注化疗后不同时间血管内皮生长因子(VEGF)水平,术后不良反应发生情况和随访期间复发情况。NMIBC患者TURBT术后复发的影响因素采用多元Logistic回归分析。结果术后8周、术后6个月,研究组患者的VEGF水平均明显低于对照组患者,差异均有统计学意义(P﹤0.01)。两组患者均未发生骨髓抑制,研究组患者并发症总发生率为9.52%,低于对照组患者的32.35%,差异有统计学意义(P﹤0.05)。术后12个月,研究组患者的复发率为21.43%,低于对照组患者的47.06%,差异有统计学意义(P﹤0.05)。研究组患者的无复发生存时间为15.41个月,明显长于对照组患者的9.89个月,差异有统计学意义(P﹤0.01)。多元Logistic回归分析结果显示,术后即刻膀胱灌注化疗药物为吡柔比星是NMIBC患者TURBT术后复发的独立危险因素(P﹤0.05)。结论NMIBC患者TURBT术后即刻进行吉西他滨灌注化疗可有效预防术后复发,延长近期无复发生存时间,不良反应发生率低。Objective To explore the effect of gemcitabine bladder infusion chemotherapy on the recurrence after transurethral resection of bladder tumor(TURBT)in patients with non-muscular invasive bladder cancer(NMIBC).Method According to the difference in chemotherapy drugs of bladder infusion,76 patients with NMIBC were divided into study group(n=42)and control group(n=34),both groups received TURBT.After operation,the patients in the study group were treated with gemcitabine,and the patients in the control group were treated with pirarubicin.The levels of vascular endothelial growth factor(VEGF)at different times after bladder infusion chemotherapy,the occurrence of postoperative adverse reactions and the recurrence during follow-up were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of recurrence of NMIBC patients after TURBT.Result At 8 weeks and 6 months after operation,the level of VEGF in the study group was significantly lower than that in the control group(P<0.01).There was no bone marrow suppression in the two groups,the total incidence of complications in the study group was 9.52%,which was lower than 32.35%in the control group,the difference was statistically significant(P<0.05).At 12 months after surgery,the recurrence rate of patients in the study group was 21.43%,which was lower than that of patients in the control group was 47.06%,the difference was statistically significant(P<0.05).The recurrencefree survival time of patients in the study group was 15.41 months,which was longer than the 9.89 months of patients in the control group,the difference was statistically significant(P<0.01).Multivariate Logistic regression analysis showed that pirarubicin was an independent risk factor for recurrence after TURBT in NMIBC patients(P<0.05).Conclusion Gemcitabine infusion chemotherapy immediately after TURBT in NMIBC patients can effectively prevent postoperative recurrence,prolong the short-term recurrence-free survival time,and have a low incid

关 键 词：膀胱灌注化疗 吉西他滨 非肌层浸润性膀胱癌 经尿道膀胱肿瘤电切术 

分 类 号：R737.14[医药卫生—肿瘤]