摘要
目的比较分析表柔比星(epirubicin,EPI)、吉西他滨(gemcitabine,GEM)膀胱灌注治疗高危非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)的临床疗效。方法回顾性分析2013-07/2016-04月期间作者科室收治的高危NMIBC患者165例,均行经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT),术后完全随机分为行辅助性EPI(EPI组,n=76)和GEM(GEM组,n=89)膀胱灌注化疗,观察两组肿瘤复发、进展及不良反应情况。结果 EPI组有3例因为出现严重的灌注副作用而终止随访,GEM组肿瘤复发率24.72%(22/89)与EPI组肿瘤复发率42.47%(31/73)比较有统计学差异(χ~2=5.738,P=0.017);GEM组肿瘤复发进展率12.36%(11/89)与EPI组肿瘤复发进展率21.92%(16/73)比较无统计学差异(χ~2=2.638,P=0.104);两组的灌注并发症无统计学差异(χ~2=2.792,P=0.095)。结论高危NMIBC术后采用EPI、GEM辅助性膀胱灌注化疗都可降低肿瘤复发率,灌注安全性高,两者对肿瘤进展无明显差别,但GEM对预防肿瘤复发的疗效优于EPI。
Objective To compare clinical efficacy of intravesical instillation of epirubicin （EPI） and gemcitabine （GEM） for high-risk non-muscle invasive bladder cancer （NMIBC）. Methods A total of 165 high-risk NMIBC patients in authors＇ hospital from July 2013 to April 2016 were retrospectively analyzed. All patients were randomly divided into auxiliary bladder perfusion chemotherapy EPI group （n = 76） and GEM group （n = 89） after implemented with transure- thral resection of bladder tumor （TURBT）. The tumor recurrence rate, time of recurrence, progression-free survival and adverse effects were evaluated. Results All patients were followed up, 3 cases in EPI group had severe perfusion side effects and stopped treatments, the tumor recurrence rate （24. 72% vs. 42. 47%） of group GEM was significantly lower than that in group EPI （Z2 = 5. 738, P = 0. 017） . There were no significantly different in tumor progression rates （12. 36% vs. 21.92%, Z2 = 2. 638, P = 0. 104） , perfusion complications （X2 = 2. 792, P = 0. 095） between groups GEM and EPL Conclusion This study suggests that intravesical chemotherapy with EPI and GEM treatment can reduce tumor recurrence, but do not reduce tumor progress. GEM for preventing tumor recurrence curative effect is superior to EPI.
出处
《华南国防医学杂志》
CAS
2017年第6期383-386,393,共5页
Military Medical Journal of South China
关键词
表柔比星
吉西他滨
灌注化疗
高危非肌层浸润性膀胱癌
Epirubicin
Gemcitabine
Perfusion chemotherapy
High-risk non-muscle invasive bladder cancer
