中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
20期
9162-9165
,共4页
周浴%李云飞%张少峰%贾洪涛%甘伟
週浴%李雲飛%張少峰%賈洪濤%甘偉
주욕%리운비%장소봉%가홍도%감위
膀胱肿瘤%化学疗法, 肿瘤, 局部灌注%吉西他滨
膀胱腫瘤%化學療法, 腫瘤, 跼部灌註%吉西他濱
방광종류%화학요법, 종류, 국부관주%길서타빈
Urinary bladder neoplasms%Chemotherapy,cancer,regional perfusion%Gemcitabine
目的：评估经尿道膀胱肿瘤电切术后行辅助性吉西他滨膀胱灌注治疗高危非肌层浸润性膀胱癌（NMIBC）的有效性及耐受性。方法80例高危NMIBC患者随机分为A、B两组，每组40例。A组给予吉西他滨2000 mg膀胱灌注，B组采用丝裂霉素40 mg膀胱灌注。观察并评估两组肿瘤复发率、复发时间、肿瘤进展率及不良反应。结果中位随访21.2个月（3.0～51.4个月），A组肿瘤复发率35.9%（14/39）与B组肿瘤复发率60%（23/38）比较有统计学差异（χ2＝4.68，P＝0.031）；A组2年肿瘤无复发生存率明显高于B组（64%±8% vs.33%±8%，χ2＝5.17，P＝0.023）；A组肿瘤复发进展率15.4%（6/39）与B组肿瘤复发进展率28.9%（11/38）比较无统计学差异（χ2＝2.06，P＝0.152）；A组25.6%（10/39）2级不良反应总数与B组47.4%（18/38）比较有统计学差异（χ2＝3.92，P＝0.048）。结论吉西他滨膀胱灌注治疗安全性高，能降低高危NMBC膀胱肿瘤复发，但对膀胱肿瘤进展无明显预防作用。
目的：評估經尿道膀胱腫瘤電切術後行輔助性吉西他濱膀胱灌註治療高危非肌層浸潤性膀胱癌（NMIBC）的有效性及耐受性。方法80例高危NMIBC患者隨機分為A、B兩組，每組40例。A組給予吉西他濱2000 mg膀胱灌註，B組採用絲裂黴素40 mg膀胱灌註。觀察併評估兩組腫瘤複髮率、複髮時間、腫瘤進展率及不良反應。結果中位隨訪21.2箇月（3.0～51.4箇月），A組腫瘤複髮率35.9%（14/39）與B組腫瘤複髮率60%（23/38）比較有統計學差異（χ2＝4.68，P＝0.031）；A組2年腫瘤無複髮生存率明顯高于B組（64%±8% vs.33%±8%，χ2＝5.17，P＝0.023）；A組腫瘤複髮進展率15.4%（6/39）與B組腫瘤複髮進展率28.9%（11/38）比較無統計學差異（χ2＝2.06，P＝0.152）；A組25.6%（10/39）2級不良反應總數與B組47.4%（18/38）比較有統計學差異（χ2＝3.92，P＝0.048）。結論吉西他濱膀胱灌註治療安全性高，能降低高危NMBC膀胱腫瘤複髮，但對膀胱腫瘤進展無明顯預防作用。
목적：평고경뇨도방광종류전절술후행보조성길서타빈방광관주치료고위비기층침윤성방광암（NMIBC）적유효성급내수성。방법80례고위NMIBC환자수궤분위A、B량조，매조40례。A조급여길서타빈2000 mg방광관주，B조채용사렬매소40 mg방광관주。관찰병평고량조종류복발솔、복발시간、종류진전솔급불량반응。결과중위수방21.2개월（3.0～51.4개월），A조종류복발솔35.9%（14/39）여B조종류복발솔60%（23/38）비교유통계학차이（χ2＝4.68，P＝0.031）；A조2년종류무복발생존솔명현고우B조（64%±8% vs.33%±8%，χ2＝5.17，P＝0.023）；A조종류복발진전솔15.4%（6/39）여B조종류복발진전솔28.9%（11/38）비교무통계학차이（χ2＝2.06，P＝0.152）；A조25.6%（10/39）2급불량반응총수여B조47.4%（18/38）비교유통계학차이（χ2＝3.92，P＝0.048）。결론길서타빈방광관주치료안전성고，능강저고위NMBC방광종류복발，단대방광종류진전무명현예방작용。
Objective To investigate the efficacy and tolerability of adjuvant gemcitabine intravesical chemotherapy after transurethral bladder tumor resection for high risk non-muscle invasive bladder cancer (NMIBC). Methods 80 patients with high-risk NMIBC patients were randomly divided into two groups (group A, n=40, group B, n=40). Group A received gemcitabine in a dose of 2000 mg and group B given 40 mg mitomycin intravesical chemotherapy. The tumor recurrence rate, time of recurrence, progression-free survival and adverse effects were evaluated. Results The median follow-up was 21.2 months(3.0 to 51.4 months), the tumor recurrence rate (35.9%vs. 60%,χ2=4.68, P=0.031) in group A was significant lower than those in group B. The recurrence-free survival rate at 2-year (64% vs. 33%, χ2=5.17, P=0.023) for group A was significantly higher than group B. There was no statistically significant difference in tumor progression rate (15.4%vs. 28.9%, χ2=2.06, P=0.152) between groups A and B. Total grade 2 adverse events (25.6%vs. 47.4%,χ2=3.92, P=0.048) for group A were lower than group B. Conclusion This study suggests that intravesical chemotherapy with gemcitabine is well tolerated and effective for the patients with high risk NMIBC, however, which treatment dose not reduce tumor progress.
