CAJ | 학술논문

目的评价羟基喜树碱(HCPT)与吉西他滨(GEM)交替序贯膀胱灌注辅助肿瘤切除术后化疗治疗非肌层浸润性膀胱癌的安全性及有效性.方法将120例原发性非肌层浸润性膀胱尿路上皮癌患者按随机分为2组,每组60例,其中60例给予HCPT 20 mg,膀胱灌注(HCPT组)1次/周,8周后每月一次,60例给予HCPT 20 mg,隔周1次,GEM1000 mg,隔周1次,交替序贯灌注(HCPTI+GEM组),8周后每月一次.随访时间12~24个月,观察并记录肿瘤复发时间及化疗不良反应.结果 2年肿瘤无复发生存率HCPT组为60.0%(36/60),HCPT+GEM组为75.0%(45/60),两组比较差异有统计学意义(P<0.05).HCPT组、HCPT+GEM组膀胱癌进展率分别为2.5%与1.7%,差异无统计学意义(P>0.05).各组间不良反应发生率差异无统计学意义(P>0.05).结论对于非肌层浸润性膀胱尿路上皮癌使用HCPT、GEM序贯膀胱灌注化疗较单用HCPT具有较好的疗效,可降低术后2年复发率,能够降低不良反应的发生率,但不能改变膀胱癌的进展.
목적 평개간기희수감(HCPT)여길서타빈(GEM)교체서관방광관주보조종류절제술후화료치료비기층침윤성방광암적안전성급유효성.방법 장120례원발성비기층침윤성방광뇨로상피암환자안수궤분위2조,매조60례,기중60례급여HCPT 20 mg,방광관주(HCPT조)1차/주,8주후매월일차,60례급여HCPT 20 mg,격주1차,GEM1000 mg,격주1차,교체서관관주(HCPTI+GEM조),8주후매월일차.수방시간12~24개월,관찰병기록종류복발시간급화료불량반응.결과 2년종류무복발생존솔HCPT조위60.0%(36/60),HCPT+GEM조위75.0%(45/60),량조비교차이유통계학의의(P<0.05).HCPT조、HCPT+GEM조방광암진전솔분별위2.5%여1.7%,차이무통계학의의(P>0.05).각조간불량반응발생솔차이무통계학의의(P>0.05).결론 대우비기층침윤성방광뇨로상피암사용HCPT、GEM서관방광관주화료교단용HCPT구유교호적료효,가강저술후2년복발솔,능구강저불량반응적발생솔,단불능개변방광암적진전.
Objective To evaluate the safety and efficacy of Hydroxycamptothecin (HCPT) and gemcitabine (GEM) alternatively sequential bladder perfusion after tumor resection for the treatment of non-muscular invasive bladder cancer. Methods 120 cases undergoing primary non-muscular layer invasive bladder urothelial carcinoma were randomly divided into two groups, 60 cases in each group. 60 cases were given HCPT 20mg, and intravesical HCPT perfusion was done once a week but once a month after 8 weeks. The other 60 cases were given HCPT 20mg and GEM 1000mg once every other week through alternating sequential perfusion (HCPTI+GEM), and then the procedure was changed into administration HCPTI+GEM once a month after 8 weeks. For all cases, the follow-up time was 12 to 24 months, and the tumor recurrence time and chemotherapy adverse reaction were observed and recorded. Results the survival rate of the tumor with no recurrence in 2 years was 60% (60/36), while HCPT+GEM group was 75% (45/60), and the difference between two groups was statistically significant (P<0.05). The progression rates of bladder cancer in the HCPT group and the HCPT+GEM group were 2.5% and 1.7% respectively, and the difference was not statistically significant (P>0.05). There were no significant differences in the incidence of adverse reactions among the groups (P>0.05). Conclusion ffor non-muscle invasive bladder urothelial carcinoma, HCPT and Gem sequential intravesical perfusion chemotherapy compared with HCPT therapy has better curative effect, with reducing postoperative 2-year recurrence rate, reducing the incidence of adverse reactions, but the progression of bladder cancer were not changed.