中高危非肌层浸润性膀胱癌热灌注化疗与常温灌注化疗的安全性和疗效对比分析
Comparative analysis the safety and efficacy of hyperthermic intravesical chemotherapy versus intravesical chemotherapy treatment alone in intermediate and high risk nonmuscle-invasive bladder cancer
阮强 1王进 1唐鸿生 1关天培 1王佳泓 1方润娅 1陈彦飞2
作者信息
- 1. 广州医科大学附属肿瘤医院胃肠外科二区,广州 510095
- 2. 广州医科大学附属肿瘤医院泌尿外科,广州 510095
- 折叠
摘要
目的 比较中高危非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤电切术后膀胱热灌注化疗(HIVEC)和膀胱灌注化疗(IVEC)的安全性和疗效.方法 回顾性纳入了2009年3月-2019年1月收治的原发性或者复发性NMIBC患者369例.根据电切术后灌注化疗方式不同,我们1∶1倾向得分匹配了 96例中高危患者并将其分为2组:IVEC组和HIVEC+IVEC组,比较两组不良反应发生率、3年无复发生存期(RFS)、再次电切手术率(sTUR)和3年总生存期(OS).结果 两组患者不良反应总发生率为35.42％,无3～4级严重不良事件发生,两组不良反应的发生率无统计学意义(P=0.393);HIVEC+IVEC 组 3 年 RFS(75.00％)高于 IVEC 组(58.33％),差异具有统计学意义(P=0.0386);HIVEC+IVEC组sTUR(14.58％)低于IVEC组(29.17％),差异具有统计学意义(P=0.0354);两组3年OS无统计学意义(P=0.543).结论 中高危NMIBC患者膀胱肿瘤电切术后行HIVEC是安全的,与单独IVEC治疗相比,HIVEC+IVEC能提高患者3年RFS,降低再次电切手术率.
Abstract
Objective To compare the safety and efficacy of hyperthermic intravesical chemotherapy(HIVEC)and intravesical chemotherapy(IVEC)after transurethral resection of bladder tumor in patients with intermediate and high risk nonmuscle-invasive bladder cancer(NMIBC).Methods We included 369 patients diagnosed with primary or recurrent NMIBC between March 2009 and January 2019.According to the different infusion chemotherapy methods after resection,we 1∶1 matched 96 patients with intermediate and high risk and divided into 2 groups:IVEC group and HIVEC+IVEC group.The incidence of adverse events,3-year recurrence-free survival(RFS),a second transurethral resection(sTUR)and 3-year overall survival(OS)were compared.Results The total incidence of adverse events in the two groups was 35.42％,no serious adverse events of grade 3-4 was occurred.The incidence of adverse events was not statistically significant between the two groups(P=0.393).The 3-year RFS in HIVEC+IVEC group was higher than IVEC group(75.00％vs 58.33％),and the difference was statistically significant(P=0.0386).The sTUR in HIVEC+IVEC group was lower than IVEC group(14.58％vs 29.17％),and the difference was statistically significant(P=0.0354).The 3-year OS of the two groups was not statistically significant(P=0.543).Conclusion HIVEC is safe after bladder tumor resection in patients with intermediate and high risk NMIBC.Compared with IVEC alone,HIVEC+IVEC can improve the 3-year RFS of patients and reduce the rate of reoperation.
关键词
非肌层浸润性膀胱癌/热疗/灌注化疗Key words
Nonmuscle-invasive bladder cancer/Hyperthermia/Intravesical chemotherapy引用本文复制引用
基金项目
广东省医学科研基金指令性课题(C2022106)
广州市卫健委一般引导项目(20231A011102)
广州市临床特色技术项目(2023C-TS57)
出版年
2023
NETL
NSTL
万方数据