摘要
目的:观察吉西他滨联合顺铂(GC)方案新辅助治疗肌层浸润性膀胱癌(MIBC)患者的疗效性及安全性。方法:回顾性分析2015年1月—2019年3月于中国医学科学院北京协和医学院肿瘤医院经病理证实的87例T2~4N0M0期行新辅助化疗(NAC)的MIBC患者的临床资料。予吉西他滨1000mg/m^(2),第1、8天静脉滴注,顺铂70mg/m^(2),分2~3d静脉滴注,共3~4个疗程,观察疗效及毒性反应,并根据化疗效果行根治性膀胱切除术(RC)或经尿道膀胱肿瘤电切术(TURBt)+放化疗同步等不同的治疗方式。结果:87例患者均完成NAC,平均疗程为3个,客观缓解率65.52%(57/87),疾病控制率为96.55%(84/87),其中完全缓解6例,部分缓解51例,疾病稳定27例,疾病进展3例;主要不良反应为骨髓抑制及消化道反应,未出现化疗相关性死亡。成功保留膀胱59例,其中行TURBt+膀胱灌注17例,TURBt+同步放化疗27例,TURBt+化疗3例,膀胱部分切除12例;行膀胱全切除术28例。结论:MIBC术前NAC有较高的反应率,且毒副作用小、具有较好的安全性及耐受性,可积极推广,并可联合手术、放疗等治疗措施保留膀胱,需要更大样本及更长时间随访进一步验证。
Objective:To observe the clinical efficacy and safety of gemcitabine+cisplatin(GC)neoadjuvant chemotherapy in the treatment of patients with muscle-invasive bladder cancer.Methods:The clinical data of 87 patients with T2-4N0M0muscle-invasive bladder cancer who underwent neoadjuvant chemotherapy in Cancer Hospital of Peking Union Medical College from January 2015to March 2019were retrospectively analyzed.Gemcitabine 1000mg/m^(2)was used for iv drip on day 1and 8,and cisplatin 70mg/m^(2)for 2to 3days,3to 4cycles.The effect and adverse reaction were observed,and then radical surgery or TURBt+chemoradiotherapy was performed according to the effect of chemotherapy.Results:Eighty-seven patients underwent neoadjuvant chemotherapy with an average of 3cycles of treatment.The objective response rate was 65.52%(57/87)and the disease control rate was 96.55%(84/87).Six cases achieved complete response(CR),while 51cases had partial response(PR),27 cases were with stable disease(SD)and progressive disease(PD)was observed in 3cases.The major adverse reactions were bone marrow suppression and gastrointestinal tract reactions,but there were no serious adverse reactions or death related to chemotherapy.The bladder-sparing treatment was performed in 59cases,including 17 cases with TURBt+bladder perfusion,27cases with TURBt+chemoradiotherapy,3cases with TURBt+chemotherapy.Twelve cases received partial cystectomy,and 28cases underwent cystectomy.Conclusion:Neoadjuvant chemotherapy for muscle-invasive bladder cancer has a high response rate,good safety and tolerability,and can be actively promoted.Combined with surgery,radiotherapy and other comprehensive treatment measures to retain bladder is indeed feasible,but a larger sample and a longer follow-up are still needed to further verify its effect.
作者
白红松
寿建忠
毕新刚
王栋
江卫星
曹传振
李长岭
胡林军
谢成明
单兴利
卢德虎
陈永海
BAI Hongsong;SHOU Jianzhong;BI Xingang;WANG Dong;JIANG Weixing;CAO Chuanzhen;LI Changling;HU Linjun;XIE Chengming;SHAN Xingli;LU Dehu;CHEN Yonghai(Department of Urology,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100021,China;Department of Urology,Cancer Hospital of HuanXing ChaoYang District Beijing)
出处
《临床泌尿外科杂志》
CAS
2021年第9期704-708,共5页
Journal of Clinical Urology
基金
北京市朝阳区科技计划项目基金(No:CYSF1918)。
关键词
膀胱癌
肌层浸润性
新辅助化疗
毒副作用
bladder cancer
muscle-invasive
neoadjuvant chemotherapy
toxicity
