CAJ | 학술논문

目的：探讨力尔凡辅助吉西他滨联合顺铂（ GC）治疗晚期膀胱尿路上皮癌的临床价值。方法膀胱尿路上皮癌患者83例，随机分为实验组（39例）和对照组（44例）。对照组单用GC化疗方案，吉西他滨1000 mg/m2，静脉滴注第1、8、15天；顺铂30 mg/m2，化疗第1～3天静脉滴注，28 d为1个疗程。实验组除给予GC方案化疗，并给予力尔凡辅助治疗。静脉滴注力尔凡20 mg＋生理盐水100 ml，每天1次，连用21天。对2组患者的临床疗效、KPS评分、不良反应等指标进行比较。结果对照组CR 5例（11．9％），PR 16例（38．1％），SD 13例（31．0％），PD 8例（19．0％）；实验组中CR 6例（15．4％），PR 20例（51．3％），SD 10例（25．6％），PD 3例（7．7％）。实验组总有效率（66．7％）虽比对照组（50．0％）提高，但是没有显著差异（P＝0．18）。实验组及对照组治疗前后KPS评分均没有显著差异，但是治疗2个周期后实验组KPS评分稳定及提高人数（34/39）比对照组（28/42）显著增加（P＝0．037）。实验组骨髓抑制比对照组较轻，其中Ⅲ～Ⅳ度白细胞降低发生率实验组显著降低（P＝0．006），且实验组周期推迟较对照组显著减少（P＝0．001）。结论力尔凡对膀胱尿路上皮癌具有一定治疗作用，而且能够保护骨髓，对减轻化疗的不良反应有一定作用，耐受性好。
목적：탐토력이범보조길서타빈연합순박（ GC）치료만기방광뇨로상피암적림상개치。방법방광뇨로상피암환자83례，수궤분위실험조（39례）화대조조（44례）。대조조단용GC화료방안，길서타빈1000 mg/m2，정맥적주제1、8、15천；순박30 mg/m2，화료제1～3천정맥적주，28 d위1개료정。실험조제급여GC방안화료，병급여력이범보조치료。정맥적주력이범20 mg＋생리염수100 ml，매천1차，련용21천。대2조환자적림상료효、KPS평분、불량반응등지표진행비교。결과대조조CR 5례（11．9％），PR 16례（38．1％），SD 13례（31．0％），PD 8례（19．0％）；실험조중CR 6례（15．4％），PR 20례（51．3％），SD 10례（25．6％），PD 3례（7．7％）。실험조총유효솔（66．7％）수비대조조（50．0％）제고，단시몰유현저차이（P＝0．18）。실험조급대조조치료전후KPS평분균몰유현저차이，단시치료2개주기후실험조KPS평분은정급제고인수（34/39）비대조조（28/42）현저증가（P＝0．037）。실험조골수억제비대조조교경，기중Ⅲ～Ⅳ도백세포강저발생솔실험조현저강저（P＝0．006），차실험조주기추지교대조조현저감소（P＝0．001）。결론력이범대방광뇨로상피암구유일정치료작용，이차능구보호골수，대감경화료적불량반응유일정작용，내수성호。
Objective To evaluate the efficacy of Lifein combined with gemcitabine and cisplatine ( GC) chemotherapy for advanced bladder urothelial carcinoma carcinoma .Methods 83 patients with bladder urothelial carcinoma were randomly di-vided into experimental group (n=39)and control group(n=44).Patients in the control group were given GC chemotherapy:In-travenous drip of Gemcitabine 1 000 mg/m2 ,d1,d8 and d15;Cisplatine 30 mg/m2 ,d1~3.Patients in the control group were giv-en Lifein beside GC.Intravenous drip of Lifein 20 mg and saline 100 ml once a day for 21 days.The clinical efficacy,KPS,and side effects were observed in two groups.Results After two treatment cycles,there was 5 complete remission (11.9%),16 par-tial remission (38.1%),13 stable disease (31.0%) and 8 progression disease (19.0%) in the control group;and in the exper-imental group,there was 6 CR (15.4%),20 PR (51.3%),10 SD (25.6%) and 3 PD (7.7%).The overall rate of curative effect of experimental group(66.7%) was higher than that of control group (50.0%),but there was no significant difference .Pa-tients with increased KPS after treatment in the experimental group (34/39) were significantly more than those (28/42) of control group(P=0.037).There was less myelosuppression,Ⅲ~Ⅳ degree reduction of leukocyte(P=0.006) and deferred cycles in the experimental group(P=0.001).Conclusion Lifein has therapeutic effect on bladder urothelial carcinoma ,and can reduce myelosuppression and other side effects caused by chemotherapy .The combination of Lifein and GC is a promising treatment for advanced bladder urothelial carcinoma .