大劑量吉西他濱膀胱灌注化療對膀胱非肌層浸潤性尿路上皮癌復發率的影響

張卓　　張文圣　　萬濱　　盧依剛　　李勛鋼

[關鍵詞] 大劑量;吉西他濱;膀胱灌注;膀胱非肌層浸潤性尿路上皮癌;復發

[中圖分類號] R737.1? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）20-0062-04

lation chemotherapy on recurrence rate of non-muscle invasive bladder urothelium carcinoma

ZHANG Zhuo? ?ZHANG Wensheng? ?WAN Bin? ?LU Yigang? ?LI Xungang

Department Ⅰ of Urology Surgery， Jiujiang No.1 People′s Hospital in Jiangxi Province， Jiujiang? ?332000， China

[Abstract] Objective To explore the clinical efficacy of high-dose gemcitabine intravesical instillation chemotherapy on non-muscle invasive bladder urothelium carcinoma and its impacts on tumor recurrence. Methods A total of 60 patients with non-muscle invasive bladder urothelium carcinoma admitted to our hospital from September 2018 to September 2019 were divided into the control group and the observation group according to the random number table method. The control group was treated with conventional dose of gemcitabine chemotherapy，while the observation group was treated with high dose of gemcitabine intravesical instillation chemotherapy. The therapeutic efficacies， tumor markers，tumor recurrence time， tumor progression time， recurrence and complications of the two groups were compared. Results The objective remission rate of the observation group was 53.33%， which was higher than 30.00% of the control group， with statistically significant difference（P<0.05）. After treatment， NSE and CEA in the observation group were （1.33±0.11）ng/mL and （3.42±1.05）ng/mL respectively， which were both lower than those in the control group， with statistically significant differences（P<0.05）. In the observation group， the 1-year tumor recurrence rate was 10.00%， the tumor recurrence time was （17.31±2.62） months and the tumor progression time was （19.87±2.96） months. While in the control group， the 1-year tumor recurrence rate was 36.67%， the tumor recurrence time was （11.42±1.33） months and the tumor progression time was （17.54±1.71）months， with statistically significant differences（P<0.05）. There was no statistically significant differences in the incidence of dysuria， hematuria， frequent micturition and myelosuppression between two groups （P>0.05）. Conclusion The application of high-dose gemcitabine intravesical instillation chemotherapy on non-muscle invasive bladder urothelium carcinoma can improve the objective remission rate， reduce serum tumor markers， decrease tumor recurrence and prolong tumor recurrence time and progression time， which is worthy of clinical promotion and application.