Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
J Healthc Eng. 2021 Nov 30;2021:2360717. doi: 10.1155/2021/2360717. eCollection 2021.
Epirubicin, gemcitabine, and pirarubicin are widely used as first-line drugs for intravesical chemotherapy to prevent tumor recurrence after transurethral bladder tumor resection for non-muscle-invasive bladder cancer (NMIBC). However, which drug is better is less discussed. A total of 335 NMIBC patients administered intravesical chemotherapy underwent transurethral bladder tumor resection (TURBT) in our hospital from October 2015 to October 2019. After TURBT, all the patients received standard intravesical chemotherapy. Through clinical data collection and telephone follow-up, the tumor recurrence and adverse reactions of all patients after bladder perfusion treatment were counted. Recurrence was defined as new tumor appearance in the bladder. Of the 335 patients who underwent intravesical chemotherapy, 109 patients received epirubicin and 114 patients and 112 patients were given gemcitabine and pirarubicin, respectively. According to the general information of the patients, the patients were divided into intermediate-risk and high-risk bladder cancer and compared separately. There was no statistical difference in clinical and pathological features between different groups ( > 0.05). The recurrence rate of intermediate-risk bladder cancer patients shows no difference between three groups ( > 0.05). As for the high-risk bladder cancer patients, it is found that the 1-year recurrence rate between three groups was not statistically significant ( > 0.05), whereas the 2-year recurrence rate of patients given gemcitabine (9.87%) was significantly lower than that of epirubicin (25.37%) and pirarubicin (24.32%), and the difference was statistically significant ( < 0.017, Bonferroni adjusted value). The Kaplan-Meier survival curves showed that the recurrence-free survival rate of patients received gemcitabine was significantly higher than that of the other two groups. Comparing the incidence of adverse reactions during the infusion of the three groups of patients, the differences were not statistically significant ( > 0.05). In patients with high-risk non-muscle-invasive bladder cancer, the application of gemcitabine intravesical chemotherapy is related with a relatively lower recurrence rate but similar incidence of adverse reactions.
表柔比星、吉西他滨和吡柔比星广泛用于非肌层浸润性膀胱癌（NMIBC）经尿道膀胱肿瘤切除术后的膀胱内化疗，以预防肿瘤复发。然而，哪种药物更好的问题讨论较少。2015 年 10 月至 2019 年 10 月，我院对 335 例 NMIBC 患者行经尿道膀胱肿瘤切除术（TURBT）后，所有患者均行标准膀胱内化疗。通过临床资料收集和电话随访，统计所有患者膀胱灌注治疗后的肿瘤复发及不良反应情况。复发定义为膀胱内出现新肿瘤。335 例接受膀胱内化疗的患者中，109 例接受表柔比星，114 例和 112 例分别接受吉西他滨和吡柔比星。根据患者一般资料，将患者分为中危和高危膀胱癌，分别进行比较。不同分组间患者的临床病理特征比较，差异无统计学意义（>0.05）。中危膀胱癌患者三组间复发率比较，差异无统计学意义（>0.05）。对于高危膀胱癌患者，三组间 1 年复发率比较，差异无统计学意义（>0.05），而吉西他滨组患者 2 年复发率（9.87%）明显低于表柔比星组（25.37%）和吡柔比星组（24.32%），差异有统计学意义（<0.017，Bonferroni 校正值）。Kaplan-Meier 生存曲线显示，吉西他滨组患者无复发生存率明显高于其他两组。比较三组患者灌注期间不良反应发生率，差异无统计学意义（>0.05）。高危非肌层浸润性膀胱癌患者应用吉西他滨膀胱内化疗与较低的复发率相关，不良反应发生率相似。
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