Adjuvant epirubicin and gemcitabine sequential perfusion therapy for non-muscle invasive bladder tumor after transurethral resection / 肿瘤研究与临床

ABSTRACT

Objective To evaluate the safety and efficacy of epirubicin (EPI) and gemcitabine (GEM) alternating sequential intravesical chemotherapy after transurethral resection in the treatment of non-muscle invasive bladder cancer.Methods 240 patients with primary non-muscle invasive bladder urothelial carcinoma were randomly divided into 2 groups.There were 120 cases for each group,EPI group was given EPI 50 mg (once a week),bladder perfusion,while the EPI+GEM group was given EPI 50 mg (once every other week),GEM 1000 mg (once every other week),alternating sequential perfusion.The follow-up time ranged from 6 to 24 months when the time of tumor recurrence and adverse reactions of chemotherapy were observed and recorded.Results The 2-year tumor free survival rate for EPI group recurrence was 60.0 ％ (72/120),and 75.0 ％ (90/120) for EPI+GEM group.There were statistical significance between the differences of the 2 groups (x2 =5.489,P ＜ 0.05).3 cases in EPI group and 2 cases in EPI+GEM group progressed to muscle invasive bladder cancer,and there was no statistical significance between the differences of bladder cancer progression rates for the 2 groups (2.5 ％ and 1.7 ％) (x2 =0.000,P ＜ 0.05).The main adverse reaction during the treatment was gastrointestinal discomfort (15 cases and 6 cases respectively),no serious haematological toxicity and other adverse reactions were frequent urination,urgency,dysuria and hematuria.The differences between the occurrence rates of adverse reactions for the 2 groups were 25.0 ％ and 11.7 ％,which were statistically significant (x2 =6.252,P ＜ 0.05).Conclusion For non-muscle invasive urothelial bladder carcinoma,the curative effect is better to use EPI and GEM sequential intravesical chemotherapy than to use EPI alone,which can not only reduce the 2 years recurrence rate after the operation,but also reduce the incidence rate of adverse reactions.Yet,this method cannot change the progress of bladder cancer.