吉西他滨联合羟喜树碱术后膀胱灌注防治初发非肌层浸润性膀胱癌术后复发的效果观察

目的 探讨吉西他滨联合羟喜树碱术后膀胱灌注防治初发非肌层浸润性膀胱癌术后复发的效果.方法将80例初发非肌层浸润性膀胱癌患者分为试验组(40例)和对照组(40例).2组患者均行经尿道膀胱肿瘤切除手术(TURBT).对照组于术后行羟喜树碱膀胱灌注,试验组采用吉西他滨联合羟喜树碱膀胱灌注.定期对患者进行随访,时间为5年,观察对比2组患者术后6个月、术后1年、术后2年、术后3年和术后5年的复发率和进展率,以及不良反应发生情况.结果治疗后,试验组和对照组在术后6个月、术后1年和术后2年的复发率方面不具有统计学差异(P均>0.05),但是在术后3年和术后5年的复发率方面差异具有统计学意义(P<0.05);术后5年2组的进展率具有统计学意义(P<0.05).试验组不良反应发生率与对照组相比,差异具有统计学意义(P<0.05).结论采用吉西他滨联合羟喜树碱术后膀胱灌注防治初发非肌层浸润性膀胱癌术后复发和单纯采用羟喜树碱防治的近期效果相近,但是远期效果显著,值得推广.

Effect of Gemcitabine Combined with Hydroxycamptothecine Postoperative Intravesical Instillation on the Prevention of Postoperative Recurrence of Primary Non Muscle Invasive Bladder Cancer

Objective To explore the effect of gemcitabine combined with hydroxycamptothecine postoperative intravesi-cal instillation on the prevention of postoperative recurrence of primary non muscle invasive bladder cancer. Methods 80 pa-tients with primary non muscle invasive bladder cancer were divided into the treatment group (n=40) and the control group (n=40). The 2 groups of patients underwent transurethral resection of bladder tumor (TURBT),the control group was treated with intravesical instillation of hydroxycamptothecin,and the treatment group was treated with gemcitabine combined with hydroxycamp-tothecin postoperative intravesical instillation . Patients were followed regularly for 5 years,The recurrence rate,progression rate and adverse reactions were compared between the 2 groups in 6 months,1 year,2 years,3 years and 5 years after operation. Re-sults After treatment,the 6-month,1-year and 2-year recurrence rates of the treatment group and the control group had no statis-tical difference (P>0. 05). but 3-year and 5-year recurrence rates had statistical difference(P<0. 05). After 5 years,the rate of progression of the 2 groups had statistical difference (P<0. 05). The incidence of adverse reactions in the experimental group compared with the control group,the difference was statistically significant (P<0. 05). Conclusion Gemcitabine combined with hydroxycamptothecine postoperative intravesical instillation has similar short-term effect as hydroxycamptothecine on the preven-tion of postoperative recurrence of primary non muscle invasive bladder cancer,but the long-term effect is significant,it is worthy of popularization.