等离子电切术联合吉西他滨膀胱灌注治疗非肌层浸润性膀胱癌的临床疗效
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摘要
目的评价经尿道等离子电切术联合吉西他滨膀胱灌注治疗非肌层浸润性膀胱癌的临床疗效。方法选取2014年1月至2016年1月黄石市中心医院应用经尿道等离子电切术联合术后吉西他滨或吡柔比星膀胱灌注化疗的非肌层浸润性膀胱癌患者84例,观察并比较两种药物灌注治疗后2年肿瘤复发率及不良反应发生率。结果两组患者的2年肿瘤复发率比较,差异无统计学意义,但吡柔比星组的不良反应发生率较吉西他滨组明显增高。结论吉西他滨膀胱灌注预防非肌层浸润性膀胱癌经尿道等离子电切术后膀胱肿瘤复发效果确切,且不良反应少,值得在临床上进一步推广应用。
Objective To evaluate the clinical effect of intravesical instillation of gemcitabine and transurethral resection of bladder tumor in the treatment of non-muscle-invasive bladder cancer.Methods From January 2014 to January 2016,84 patients with non-muscle-invasive infiltration bladder cancer who underwent transurethral resection of prostatectomy combined with postoperative intravesical instillation of gemcitabine or pirarubicin in Huangshi Center Hospital were selected.The2-year tumor recurrence rate and incidence of adverse reactions in both groups were observed and compared. Result There was no significant difference in 2-year tumor recurrence rates between the two groups,but the incidence of adverse reactions in the pirarubicin group was significantly higher than that in the gemcitabine group. Conclusions The bladder infusion of gemcitabine in bladder cancer patients has definite effect and low incidence of adverse reactions.It is worth further promoting in the clinical application.
Objective To evaluate the clinical effect of intravesical instillation of gemcitabine and transurethral resection of bladder tumor in the treatment of non-muscle-invasive bladder cancer.Methods From January 2014 to January 2016,84 patients with non-muscle-invasive infiltration bladder cancer who underwent transurethral resection of prostatectomy combined with postoperative intravesical instillation of gemcitabine or pirarubicin in Huangshi Center Hospital were selected.The2-year tumor recurrence rate and incidence of adverse reactions in both groups were observed and compared. Result There was no significant difference in 2-year tumor recurrence rates between the two groups,but the incidence of adverse reactions in the pirarubicin group was significantly higher than that in the gemcitabine group. Conclusions The bladder infusion of gemcitabine in bladder cancer patients has definite effect and low incidence of adverse reactions.It is worth further promoting in the clinical application.
引文
[1]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014:36-42.
[2] Gontero P,Frea B.Actual experience and future development of gemcitabine in superficial bladder cancer[J].Ann Oncol,2006,17Suppl 5:v123-8.
[3] Farr SE,Chess-Williams R,McDermott CM.Gemcitabine:Selective cytotoxicity,induction of inflammation and effects on urothelial function[J].Toxicol Appl Pharmacol,2017,316:1-9.
[4] Prasanna T,Craft P,Balasingam G,et al.Intravesical Gemcitabine versus Intravesical Bacillus Calmette-Guerin for the Treatment of Non-Muscle Invasive Bladder Cancer:An Evaluation of Efficacy and Toxicity[J].Front Oncol,2017,7:260.
[5] Gontero P,Oderda M,Mehnert A,et al.The impact of intravesical gemcitabine and 1/3dose Bacillus Calmette-Guerin instillation therapy on the quality of life in patients with nonmuscle invasive bladder cancer:results of a prospective,randomized,phase 2trial[J].J Urol,2013,190(3):857-62.
[6]Mohanty NK,Nayak RL,Vasudeva P,et al.Intravesicle gemcitabine in management of BCG refractory superficial TCC of urinary bladder-our experience[J].Urol Oncol,2008,26(6):616-619.
[7]王敏捷,王尉,胡卫列,等.经尿道等离子膀胱肿瘤切除术中经膀胱黏膜下注射吉西他滨治疗非前壁的非肌层浸润性膀胱癌[J].中国微创外科杂志,2016,16(8):689-693.
[2] Gontero P,Frea B.Actual experience and future development of gemcitabine in superficial bladder cancer[J].Ann Oncol,2006,17Suppl 5:v123-8.
[3] Farr SE,Chess-Williams R,McDermott CM.Gemcitabine:Selective cytotoxicity,induction of inflammation and effects on urothelial function[J].Toxicol Appl Pharmacol,2017,316:1-9.
[4] Prasanna T,Craft P,Balasingam G,et al.Intravesical Gemcitabine versus Intravesical Bacillus Calmette-Guerin for the Treatment of Non-Muscle Invasive Bladder Cancer:An Evaluation of Efficacy and Toxicity[J].Front Oncol,2017,7:260.
[5] Gontero P,Oderda M,Mehnert A,et al.The impact of intravesical gemcitabine and 1/3dose Bacillus Calmette-Guerin instillation therapy on the quality of life in patients with nonmuscle invasive bladder cancer:results of a prospective,randomized,phase 2trial[J].J Urol,2013,190(3):857-62.
[6]Mohanty NK,Nayak RL,Vasudeva P,et al.Intravesicle gemcitabine in management of BCG refractory superficial TCC of urinary bladder-our experience[J].Urol Oncol,2008,26(6):616-619.
[7]王敏捷,王尉,胡卫列,等.经尿道等离子膀胱肿瘤切除术中经膀胱黏膜下注射吉西他滨治疗非前壁的非肌层浸润性膀胱癌[J].中国微创外科杂志,2016,16(8):689-693.