吉西他滨联合顺铂新辅助化疗方案治疗晚期局部膀胱癌的效果研究  

Effect of Gemcitabine and Cisplatin Neoadjuvant Chemotherapy on Advanced Local Bladder Cancer

作　　者：张新军[1] ZHANG Xinjun(Anyang Second People's Hospital,Anyang,455000)

机构地区：[1]河南省安阳市第二人民医院,455000

出　　处：《实用癌症杂志》2022年第4期656-658,663,共4页The Practical Journal of Cancer

摘　　要：目的探讨吉西他滨联合顺铂(GP)新辅助化疗方案治疗晚期局部膀胱癌的有效性和安全性。方法选取局部晚期膀胱癌62例患者作为研究对象,随机分为对照组和观察组,每组各31例,对照组行常规对症与顺铂治疗,观察组给予GP新辅助化疗方案治疗,分析两组患者的疾病有效率、血管内皮生长因子(VEGF)、β_(2)微球蛋白(β_(2)-MG)、细胞角蛋白19片段(CYFRA-21)水平、患者复发及生存情况、药物的不良反应。结果对照组和观察组疾病有效率分别为38.71%和64.52%,差异显著(P<0.05);两组患者治疗前VEGF、β_(2)-MG、CYFRA21-1水平差异不显著(P>0.05),治疗后两组患者上述指标均较治疗前降低,观察组低于对照组,差异显著(P<0.05);随访期间,对照组复发率为48.39%,中位生存时间为(16.63±1.78)个月,生存率为67.74%(21/31),观察组复发率为22.58%,中位生存时间为(21.58±2.02)个月,生存率为90.32%(28/31),两组比较差异显著(P<0.05);两组患者药物不良反应差异不显著(P>0.05)。结论GP新辅助化疗方案治疗短期内可获得较高的疾病缓解率,扩大手术适应证,改善患者预后具有较高的安全性。Objective To explore the efficacy and safety of gemcitabine and cisplatin(GP)neoadjuvant chemotherapy in the treatment of advanced local bladder cancer.Methods The 62 patients with locally advanced bladder cancer were randomly divided into the control group and the observation group,with 31 cases in each group.The control group received conventional symptomatic and cisplatin treatment,and the observation group received GP neoadjuvant chemotherapy.The disease effectiveness,vascular endothelial growth factor(VEGF),β_(2) microglobulin(β_(2)-MG),cytokeratin 19 fragment(CYFRA-21)levels,patient relapse and survival,and adverse drug reactions were compared between the 2 groups.Results The effective rate of treatment in the observation group was higher than that in the control group(64.53%vs.38.71%,P<0.05).There was no significant difference in the levels of VEGF,β_(2)-MG,and CYFRA21-1 between the 2 groups of patients before treatment(P>0.05).The above indexes of the 2 groups of patients were lower than those before treatment,and the observation group was lower than those in the control group(P<0.05);During the follow-up period,the recurrence rate of the observation group was lower than that of the control group(22.58%vs.48.39%,P<0.05),the median survival time was longer than that in the control group((21.58±2.02)months vs.(16.63±1.78)months,P<0.05),the survival rate higher than that in the control group(90.32%vs.67.74%).There was no significant difference in adverse drug reactions between the 2 groups of patients(P>0.05).Conclusion GP neoadjuvant chemotherapy can achieve higher disease remission rate in the short term,expand surgical indications,improve patient prognosis,and have higher safety.

关 键 词：吉西他滨 顺铂 新辅助化疗 晚期局部膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤]