|本期目录/Table of Contents|

[1]李 欢,王金颖,王 琳,等.保留膀胱的放疗同步小剂量吉西他滨化疗治疗肌层浸润性膀胱癌的疗效[J].天津医科大学学报,2017,23(03):235-238.
　LI Huan,WANG Jin-ying,WANG Lin,et al.Effect of bladder-sparing low-dose gemcitabine combined with radiotherapy in treatment of muscle-invasive bladder cancer[J].Journal of Tianjin Medical University,2017,23(03):235-238.
点击复制

保留膀胱的放疗同步小剂量吉西他滨化疗治疗肌层浸润性膀胱癌的疗效(PDF)
分享到：

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
23卷
期数:
2017年03期
页码:
235-238
栏目:
临床医学
出版日期:
2017-05-18

文章信息/Info

Title:
Effect of bladder-sparing low-dose gemcitabine combined with radiotherapy in treatment of muscle-invasive bladder cancer
文章编号:
1006-8147(2017)03-0235-04
作者:

李 欢; 王金颖; 王 琳; 魏 巧; 李小东

（天津医科大学第二医院放射治疗科，天津 300211）
Author(s):
LI Huan;  WANG Jin-ying;  WANG Lin;  WEI Qiao;  LI Xiao-dong
(1.Department of Radiation Therapy, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)
关键词:
肌层浸润性膀胱癌; 保留膀胱; 同步放化疗; 吉西他滨
Keywords:
muscle-invasivebladdercancer;  bladder-sparing;  synchronouschemoradiotherapy;  gemcitabine
分类号:
R737.14
DOI:
-
文献标志码:
A
摘要:
目的：探讨保留膀胱的放疗同步小剂量吉西他滨（GEM）化疗对肌层浸润性膀胱癌（MIBC）患者的疗效。方法：回顾性分析63例MIBC患者的临床资料。其中，34例行保留膀胱的综合治疗（观察组），29例行单纯放射治疗（对照组）。两组患者均接受经尿道膀胱肿瘤电切术（TURBT），术后观察组采用常规分割的方式行膀胱根治性放射治疗，并从放疗第1天开始接受75 mg/m2的小剂量GEM同步化疗；对照组术后仅进行膀胱根治性放疗。观察并比较两组的近期疗效、2年生存率及不良反应发生率。结果：观察组近期临床疗效有效率为79.4%，高于对照组55.2%（P<0.05）；观察组与对照组3～4度不良反应发生率相比无统计学差异（44.1% vs. 27.6%，P=0.174）；观察组和对照组的2年总生存时间比较无统计学差异（P=0.752），其2年无进展生存时间相比有明显差异（P=0.043）。结论：对于MIBC患者TURBT术后行膀胱根治性放疗同步小剂量GEM化疗，与单纯放疗相比可显著提高无病生存率，降低局部复发及进展的可能，且不良反应发生率无明显差异。
Abstract:
Objective ：To detect the efficacy of the bladder-sparing synchronous chemotherapy with low-dose GEM chemotherapy combined with radiotherapy in treatment of local MIBC. Methods： Sixty-three MIBC cases were treated by TURBT. Thirty-four cases (observation group) underwent the bladder-sparing synchronous chemotherapy with GEM at 75 mg/m2 per week combined with radiotherapy. Twenty-nine cases (control group) underwent radiotherapy without chemotherapy. PFS and OS after 2 years were compared, together with short-term efficiency and toxic effects. Results：At 2 years, rates of PFS were 73.5% in the observation group and 48.3% in the control group, with statistical differences between them (P=0.043). Short-term efficiency were 79.4% and 55.2% in the observation group and control group, with significant differences. There were no significant differences between observation group and control group in the OS (79.4% vs. 75.9%, P>0.05) and toxic effects (44.1% vs. 27.6%, P>0.05). Conclusion：The bladder-sparing synchronous chemotherapy with low-dose GEM combined with radiotherapy can significantly improv locoregional control of MIBC, as compared to radiotherapy alone, with no significant increase in adverse events.

参考文献/References:

[1] Kerr M, Scott H E, Groselj B, et al. Deoxycytidine kinase expression underpins response to gemcitabine in bladder cancer[J]. Clin Cancer Res， 2014， 20(21): 5435

[2] 范欣荣, 李汉忠, 纪志刚,等. 保留器官的综合治疗-膀胱癌治疗的新模式（附107例报告）[J]. 中华泌尿外科杂志 ， 2016，37 (2): 131

[3] Choudhury A, Swindell R, Logue J P, et al. Phase II study of conformal hypofractionated radiotherapy with concurrent gemcitabine in muscle-invasive bladder cancer[J]. J Clin Oncol， 2011， 29(6): 733

[4] Kaufman D S, Shipley W U, Feldman A S. Bladder cancer. Lancet， 2009， 374(9685): 239

[5] Gakis G, Efstathiou J, Lerner SP, et al. ICUD-EAU International Consultation on Bladder Cancer 2012: Radical cystectomy and bladder preservation for muscle-invasive urothelial carcinoma of the bladder[J]. Eur Urol， 2013， 63(1): 45

[6] James N D, Hussain S A, Hall E, et al. Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer[J]. N Engl J Med， 2012.，366(16): 1477

[7] Hautmann R E, de Petriconi R C, Volkmer B G. Lessons learned from 1,000 neobladders: the 90-day complication rate[J]. J Urol.，2010，184(3): 990

[8] 龚虹云, 宋启斌, 胡伟国, 等.根治性放疗与根治性手术治疗肌层浸润性膀胱癌的Meta分析[J]. 中国肿瘤,2013, 22(8): 671

[9] 沈捷, 刘峡, 张福泉,等. 109例膀胱癌三维适形放疗临床分析[J]. 中华放射肿瘤学杂志, 2009, 18(2): 115

[10] Cooke P W, Dunn J A, Latief T, et al. Long-term risk of salvage cystectomy after radiotherapy for muscle-invasive bladder cancer[J]. Eur Urol, 2000,38(3): 279.

[11] 夏永丽, 霍红, 刘华群,等. 适形放疗联合吉西他滨及表阿霉素治疗老年晚期膀胱癌的临床观察[J]. 中国老年学杂志，2011， 31(8): 1331

[12] Hussain S A, Moffitt D D, Glaholm J G, et al. A phase I-II study of synchronous chemoradiotherapy for poor prognosis locally advanced bladder cancer[J]. Ann Oncol, 2001, 12(7): 929

[13] 吴稚冰, 马胜林. 吉西他滨的放射增敏作用研究进展[J]. 临床肿瘤学杂志, 2004, 9(2): 200

[14] Shewach D S, Lawrence T S. Radiosensitization of human tumor cells by gemcitabine in vitro[J]. Semin Oncol,1995, 22(4 Suppl 11): 68

[15] Crane C H, Wolff R A, Abbruzzese J L, et al. Combining gemcitabine with radiation in pancreatic cancer: understanding important variables influencing the therapeutic index[J]. Semin Oncol, 2001, 28(3 Suppl 10): 25

[16] Choudhury A, Swindell R, Logue J P, et al. Phase II study of conformal hypofractionated radiotherapy with concurrent gemcitabine in muscle-invasive bladder cancer[J]. J Clin Oncol, 2011, 29(6): 733

[17] Atasoy B M, Dane F, Alsan C I, et al. Concurrent chemoradiotherapy with low dose weekly gemcitabine in medically inoperable muscle-invasive bladder cancer patients[J]. Clin Transl Oncol, 2014, 16(1): 91

相似文献/References:

备注/Memo

备注/Memo:

作者简介 李欢（1990-），女，硕士在读，研究方向：影像医学与核医学；通信作者：李小东，E-mail: lixiaodonglxd@l63.com。



更新日期/Last Update: 2017-05-18