大剂量吉西他滨膀胱灌注化疗对膀胱非肌层浸润性尿路上皮癌复发率的影响

目的探讨大剂量吉西他滨膀胱灌注化疗在膀胱非肌层浸润性尿路上皮癌中的临床效果及对肿瘤复发的影响。方法选取2018年9月至2019年9月在本院治疗的膀胱非肌层浸润性尿路上皮癌患者60例,按照数字表法随机分为对照组与观察组,对照组采用常规剂量吉西他滨化疗,观察组采用大剂量吉西他滨膀胱灌注化疗,比较两组治疗效果、肿瘤标记物、肿瘤复发时间、肿瘤进展时间、复发情况及并发症情况。结果观察组客观缓解率为53.33%,高于对照组的30.00%,差异有统计学意义(P0.05)。观察组治疗后NSE为(1.33±0.11)ng/mL,CEA为(3.42±1.05)ng/mL,均低于对照组,差异有统计学意义(P0.05)。观察组1年肿瘤复发率为10.00%,肿瘤复发时间(17.31±2.62)个月,肿瘤进展时间(19.87±2.96)个月;对照组1年肿瘤复发率为36.67%,肿瘤复发时间(11.42±1.33)个月,肿瘤进展时间(17.54±1.71)个月,差异有统计学意义(P0.05)。两组治疗期间尿痛、血尿、尿频、骨髓抑制发生率比较,差异无统计学意义(P0.05)。结论大剂量吉西他滨膀胱灌注化疗应用于膀胱非肌层浸润性尿路上皮癌中能够提升肿瘤客观缓解率,降低血清肿瘤标记物,减少肿瘤复发,延长肿瘤复发时间和进展时间,值得在临床推广应用。

lation chemotherapy on recurrence rate of non-muscle invasive bladder urothelium carcinoma

Objective To explore the clinical efficacy of high-dose gemcitabine intravesical instillation chemotherapy on non-muscle invasive bladder urothelium carcinoma and its impacts on tumor recurrence.Methods A total of 60 patients with non-muscle invasive bladder urothelium carcinoma admitted to our hospital from September 2018 to September 2019 were divided into the control group and the observation group according to the random number table method.The control group was treated with conventional dose of gemcitabine chemotherapy,while the observation group was treated with high dose of gemcitabine intravesical instillation chemotherapy.The therapeutic efficacies,tumor markers,tumor recurrence time,tumor progression time,recurrence and complications of the two groups were compared.Results The objective remission rate of the observation group was 53.33%,which was higher than 30.00% of the control group,with statistically significant difference (P<0.05).After treatment,NSE and CEA in the observation group were(1.33±0.11)ng/mL and (3.42±1.05)ng/mL respectively,which were both lower than those in the control group,with statistically significant differences (P<0.05).In the observation group,the 1-year tumor recurrence rate was 10.00%,the tumor recurrence time was (17.31±2.62) months and the tumor progression time was (19.87±2.96) months.While in the control group,the 1-year tumor recurrence rate was 36.67%,the tumor recurrence time was (11.42±1.33) months and the tumor progression time was (17.54±1.71)months,with statistically significant differences(P<0.05).There was no statistically significant differences in the incidence of dysuria,hematuria,frequent micturition and myelosuppression be tween two groups (P>0.05).Conclusion The application of high-dose gemcitabine intravesical instillation chemotherapy on non-muscle invasive bladder urothelium carcinoma can improve the objective remission rate,reduce serum tumor markers,decrease tumor recurrence and prolong tumor recurrence time and progression time,which is worthy of clinical promotion and application.