Tripathy Rachana, Kumar Lalit, Agarwal Sakshi, Thakur Anuja, Khairnar Mahesh, Trivedi Sameer, Sankhwar Satya N
Department of Obstetrics & Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Urology. 2025 May;199:171-178. doi: 10.1016/j.urology.2025.01.004. Epub 2025 Jan 9.
This study evaluated the efficacy, recurrence rates, and safety of intravesical gemcitabine plus docetaxel compared to standard Bacillus Calmette-Guérin (BCG) therapy for treating naïve non-muscle-invasive bladder cancer (NMIBC), with a focus on reducing recurrence and progression concerns associated with transurethral resection (TURBT). A systematic review and meta-analysis of three original studies were conducted, assessing recurrence rates and safety profiles. The meta-analysis revealed no heterogeneity in recurrence rates between the gemcitabine plus docetaxel and BCG groups, with an overall Odds Ratio for recurrence of 0.72 (95% CI: 0.36-1.47). Although the clinical recurrence rate was slightly lower in the gemcitabine plus docetaxel group, the difference was not statistically significant (Z = 0.89, P = 0.37). The gemcitabine plus docetaxel group experienced fewer severe side effects compared to the BCG group. Due to the limited number of studies available, further randomized trials are necessary to confirm the role of intravesical gemcitabine plus docetaxel in NMIBC management.
本研究评估了膀胱内注射吉西他滨联合多西他赛与标准卡介苗（BCG）疗法治疗初治非肌层浸润性膀胱癌（NMIBC）的疗效、复发率和安全性，重点是减少经尿道膀胱肿瘤切除术（TURBT）相关的复发和进展问题。对三项原始研究进行了系统评价和荟萃分析，评估复发率和安全性。荟萃分析显示，吉西他滨联合多西他赛组和BCG组的复发率无异质性，复发的总体比值比为0.72（95%CI：0.36-1.47）。虽然吉西他滨联合多西他赛组的临床复发率略低，但差异无统计学意义（Z = 0.89，P = 0.37）。与BCG组相比，吉西他滨联合多西他赛组出现的严重副作用较少。由于现有研究数量有限，有必要进行进一步的随机试验，以确认膀胱内注射吉西他滨联合多西他赛在NMIBC治疗中的作用。
