吉西他滨联合顺铂新辅助化疗治疗肌层浸润性膀胱癌的临床疗效观察

发布时间：2018-06-22 19:03

本文选题：肌层浸润性膀胱癌 + 吉西他滨　；参考：《泌尿外科杂志(电子版)》2014年02期

【摘要】：目的观察和探讨吉西他滨、顺铂(GC)方案新辅助化疗治疗肌层浸润性膀胱癌(MIBC)患者的临床疗效及安全性。方法回顾性分析MIBC患者69例,予以吉西他滨800～1000mg/m2,第1、8、15天静脉滴注;顺铂25mg/m2,第1～3天静脉滴注的3～4个疗程新辅助化疗。化疗结束后依据患者病情选择不同手术方式治疗,随访记录不良反应,比较新辅助化疗前后肿瘤最大径和最小径的差异。结果行GC方案新辅助化疗的平均疗程为3.5个,完全应答率27.9%(19/68),部分应答率22.1%(15/68);临床获益率79.4%(54/68);疾病进展率20.6%(14/68)。随访期4～55个月,中位随访期20个月,中位应答期16个月。化疗后肿瘤最大径及最小径明显减小,差异均具有统计学意义(P0.05)。主要毒性反应为骨髓抑制及消化道反应是,未出现化疗相关严重不良反应所致化疗相关性死亡。结论在短期内,3～4个疗程GC方案新辅助化疗可获得较高的应答率,显著减小肿瘤体积,具有可靠的安全性及耐受性。
[Abstract]:Objective to observe the clinical efficacy and safety of gemcitabine and cisplatin (GC) regimen in the treatment of myometrial invasive bladder cancer (MIBC). Methods Sixty-nine patients with MIBC were treated with gemcitabine 800 mg / m ~ (2) and cisplatin 25 mg / m ~ (2) and 3 ~ (th) days of neoadjuvant chemotherapy respectively. After chemotherapy, different surgical methods were selected according to the patient's condition. Adverse reactions were recorded and the difference of tumor maximum diameter and minimal path before and after neoadjuvant chemotherapy was compared. Results the average course of neoadjuvant chemotherapy for GC regimen was 3.5, the complete response rate was 27.9% (19 / 68), the partial response rate was 22.1% (15 / 68), the clinical benefit rate was 79.4% (54 / 68), and the disease progression rate was 20.6% (14 / 68). The follow-up period was 4 ~ 55 months, the median follow-up period was 20 months and the median response period was 16 months. After chemotherapy, the maximum diameter and the minimum diameter of the tumor decreased significantly, the difference was statistically significant (P0.05). The main toxic reactions were myelosuppression and digestive tract reaction. Conclusion Neoadjuvant chemotherapy with GC regimen in a short period of 3 ~ 4 courses can obtain high response rate, significantly reduce tumor volume, and has reliable safety and tolerance.
【作者单位】：山东大学附属省立医院泌尿微创中心;
【分类号】：R737.14

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