CAJ | 학술논문

目的评价吉西他滨膀胱灌注化疗治疗常规膀胱灌注化疗(包括丝裂霉素、表阿霉素和羟基喜树碱)失败的非肌层浸润性膀胱癌(NMIBC)的安全性及有效性.方法将72例在持续常规膀胱灌注化疗1年内出现肿瘤复发的NMIBC患者分为A、B、C 3组,每组24例.A组给予吉西他滨1000 mg灌洗,B组给予吉西他滨2000 mg灌洗,C组继续采用原化疗方案灌洗.观察并记录肿瘤复发时间及化疗不良反应.结果 A、B、c组患者的2年肿瘤无复发生存率分别为66.7%、75.0%和45.8%,采用吉西他滨灌洗患者的2年无瘤生存率达70.8%,显著高于传统化疗方案(45.8%,P<0.05),但A组与B组间未见明显差异.A组与B组中各有I例患者发生肾功能不全,其余不良反应主要为尿频、尿急、尿痛、血尿等,经对症治疗后缓解,各组间未见有明显差异,未发生严重的血液学不良反应.结论对于常规膀胱灌注化疗后复发的NMIBC患者可考虑采用吉西他滨膀胱灌注化疗,但需注意观察患者的肾功能改变.
목적 평개길서타빈방광관주화료치료상규방광관주화료(포괄사렬매소、표아매소화간기희수감)실패적비기층침윤성방광암(NMIBC)적안전성급유효성.방법 장72례재지속상규방광관주화료1년내출현종류복발적NMIBC환자분위A、B、C 3조,매조24례.A조급여길서타빈1000 mg관세,B조급여길서타빈2000 mg관세,C조계속채용원화료방안관세.관찰병기록종류복발시간급화료불량반응.결과 A、B、c조환자적2년종류무복발생존솔분별위66.7%、75.0%화45.8%,채용길서타빈관세환자적2년무류생존솔체70.8%,현저고우전통화료방안(45.8%,P<0.05),단A조여B조간미견명현차이.A조여B조중각유I례환자발생신공능불전,기여불량반응주요위뇨빈、뇨급、뇨통、혈뇨등,경대증치료후완해,각조간미견유명현차이,미발생엄중적혈액학불량반응.결론 대우상규방광관주화료후복발적NMIBC환자가고필채용길서타빈방광관주화료,단수주의관찰환자적신공능개변.
Objective To evaluate the efficacy and safety of intravesical instillation with gemcitabine after first-line intravesical chemotherapy failure, including mitomycin ( MMC), epirubicin (EPB) and camptothecin- (CPT), in the treatment of non-muscle-invasive bladder cancer (NMIBC). Methods From June 2007 to October 2008, 72 patients with NMIBC, who had tumor recurrence within one year of first-line intravesical chemotherapy, were assigned to 3 groups (24 cases each). Croup A received intravesical gemcitabine in a dose of 1000 mg, Group B received 2000 mg gemcitabine, and Group C received original intravesical chemotherapy. The time of reccurrence and adverse effects were recorded. Results The 2-year tumor free survival rates of the 3 groups were 66.7% , 75.0% and 45.8% , respectively. The 2-year TFS rate of the patients who received gemcitabine was 70.8% , significantly higher than 45.8% of the patients treated by original chemotherapy. There was one case with renal function impairement in the groups A and B, respectively. There was no significant difference between the rates of low urinary tract symptoms in the 3 groups. No severe hematological side effects were observewd in this study. Conclusion The intravescal chemotherapy with gemcitabine in patients with recurrent bladder tumor after first-line intravesical chemotherapy is effective and well tolerated, however, renal function should be routinely assessed.