Harada Ken-Ichi, Miyake Hideaki, Terakawa Tomoaki, Fujisawa Masato
Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Curr Urol. 2012 May;6(1):27-32. doi: 10.1159/000338866. Epub 2012 Apr 30.
The objective of this study was to assess the role of uracil/tegafur (UFT) and its metabolite γ-butyrolactone (GBL), a potent inhibitor of angiogenesis, in the prevention of intravesical recurrence in patients with non-muscle invasive urothelial carcinoma of the bladder (NMIUCB).
This study included 48 patients with NMIUCB following complete transurethral resection who were randomly divided into 27 receiving UFT therapy (group A) and 21 without any adjuvant therapies (group B). Serum levels of GBL, vascular endothelial growth factor, basic fibroblast growth factor, platelet-derived growth factor and interleukin-8 were measured.
There was no significant difference in the intravesical recurrence-free survival between groups A and B. Despite the lack of significant differences in serum levels of vascular endothelial growth factor, basic fibroblast growth factor, platelet-derived growth factor and interleukin-8, serum GBL in group A was significantly greater than in group B. Multivariate analysis identified tumor size as an independent predictor of intravesical recurrence irrespective of the other factors examined.
Despite the significant induction of GBL, adjuvant UFT therapy failed to show a preventive effect on intravesical recurrence of NMIUCB. Therefore, we should consider enhancing the anti-angiogenic effect of GBL using an alternative administration schedule of UFT.
本研究的目的是评估尿嘧啶/替加氟(UFT)及其代谢产物γ-丁内酯(GBL,一种有效的血管生成抑制剂)在预防非肌层浸润性膀胱尿路上皮癌(NMIUCB)患者膀胱内复发中的作用。
本研究纳入48例经尿道完全切除术后的NMIUCB患者,随机分为两组,27例接受UFT治疗(A组),21例未接受任何辅助治疗(B组)。检测血清GBL、血管内皮生长因子、碱性成纤维细胞生长因子、血小板衍生生长因子和白细胞介素-8水平。
A组和B组膀胱内无复发生存率无显著差异。尽管血管内皮生长因子、碱性成纤维细胞生长因子、血小板衍生生长因子和白细胞介素-8的血清水平无显著差异,但A组血清GBL显著高于B组。多因素分析确定肿瘤大小是膀胱内复发的独立预测因素,与其他检查因素无关。
尽管GBL诱导显著,但辅助UFT治疗未能显示出对NMIUCB膀胱内复发的预防作用。因此,我们应考虑使用UFT的替代给药方案增强GBL的抗血管生成作用。