榄香烯与表柔比星预防低级别浅表性膀胱尿路上皮癌术后复发疗效对比
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摘要
目的对比榄香烯与表柔比星膀胱灌注预防低级别浅表性膀胱尿路上皮癌经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT术)后复发的临床疗效和安全性。方法选取2015年1月-2018年1月在四川省雅安市人民医院行TURBT术的膀胱尿路上皮癌患者230例,采用Excel随机数字表法将患者随机分为2组,其中榄香烯干预组115例采用榄香烯进行膀胱灌注,表柔比星组115例采用表柔比星进行膀胱灌注。随访2年,观察2组患者的复发膀胱癌率、无病生存期及药物不良反应。结果榄香烯干预组总复发率为15.75%,略高于表柔比星组的15.62%,差异无统计学意义(χ~2=0.563,P=0.453)。榄香烯干预组平均无病生存期为(22.068±0.653)个月,表柔比星组平均无病生存期为(22.482±0.592)个月,差异无统计学意义(χ~2=0.385,P=0.535)。2组不良反应发生率比较,在膀胱刺激症状(χ~2=6.467,P=0.011)、血尿(χ~2=4.705,P=0.030)方面差异具有统计学意义(P<0.05)。结论榄香烯与表柔比星膀胱灌注化疗在预防TURBT术后低级别浅表性膀胱尿路上皮癌复发率、无病生存期相当,但榄香烯膀胱灌注疗效良好,不良反应少,值得临床推广。
Objective To investigate the clinical efficacy and safety of element and eirenicon in the treatment of recurrent bladder cancer after TURBT in low-grade superficial bladder urothelial carcinoma. Methods A total of 230 patients in Yanan People′s Hospital with bladder urothelial carcinoma who underwent transurethral resection of bladder tumors(TURBT) from January 2015 to January 2018 were randomly divided into 2 groups according to the order of enrollment by using Excel random number table method. Among them, 115 patients in the element intervention group were treated with element for bladder infusion, and 115 patients in the control group were treated with eirenicon for bladder perfusion. After two years of follow-up, the recurrence of bladder cancer, disease-free survival and adverse drug reactions were observed in the two groups. Results The total recurrence rate of the element intervention group was 15.75%, which was slightly higher than the 15.61% of the control group. The difference was not statistically significant(χ~2=0.563, P=0.453). The difference of average disease-free survival time between two groups were also not statistically significant(χ~2=0.385, P=0.535). The incidence of adverse reactions in the two groups was statistically significant(P<0.05) in bladder irritation(χ~2=6.467, P=0.011) and hematuria(χ~2=4.705, P=0.030). Conclusion Intravesical chemotherapy with element and eirenicon can prevent the recurrence rate and disease-free survival of low-grade superficial bladder urothelial carcinoma after TURBT. But elemene bladder perfusion has good efficacy and fewer adverse reactions, which is worthy of clinical promotion.
Objective To investigate the clinical efficacy and safety of element and eirenicon in the treatment of recurrent bladder cancer after TURBT in low-grade superficial bladder urothelial carcinoma. Methods A total of 230 patients in Yanan People′s Hospital with bladder urothelial carcinoma who underwent transurethral resection of bladder tumors(TURBT) from January 2015 to January 2018 were randomly divided into 2 groups according to the order of enrollment by using Excel random number table method. Among them, 115 patients in the element intervention group were treated with element for bladder infusion, and 115 patients in the control group were treated with eirenicon for bladder perfusion. After two years of follow-up, the recurrence of bladder cancer, disease-free survival and adverse drug reactions were observed in the two groups. Results The total recurrence rate of the element intervention group was 15.75%, which was slightly higher than the 15.61% of the control group. The difference was not statistically significant(χ~2=0.563, P=0.453). The difference of average disease-free survival time between two groups were also not statistically significant(χ~2=0.385, P=0.535). The incidence of adverse reactions in the two groups was statistically significant(P<0.05) in bladder irritation(χ~2=6.467, P=0.011) and hematuria(χ~2=4.705, P=0.030). Conclusion Intravesical chemotherapy with element and eirenicon can prevent the recurrence rate and disease-free survival of low-grade superficial bladder urothelial carcinoma after TURBT. But elemene bladder perfusion has good efficacy and fewer adverse reactions, which is worthy of clinical promotion.
引文
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[5] 赵永顺,吴春明,董斌,等.榄香烯抑制Raf/MEK/ERK信号通路诱导人源胶质瘤U87细胞凋亡[J].实用药物与临床,2011,14(5):365-367.
[6] 李传刚,李墨林,舒晓宏,等.β-榄香烯对人膀胱癌 BIU87 细胞磷脂代谢转换率及细胞脂膜流动性的影响[J].中华医学杂志,2004,84(5):416-417.
[7] LI G, XIE B, LI X, et al. Downregulation of peroxiredoxin-1 by ? β-elemene enhances the radiosensitivity of lung adenocarcinoma xenografts[J]. Oncol Rep, 2015, 33(3):1427-1433.
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[9] UEKADO Y,HIRANO A,SHINKA T,et al.The effects of intravesicalchemoimmunotherapy with epirubicin and bacillus Calmette-Guerin for prophylaxis of recurrence of superficial bladder cancer: a preliminary report [J].Cancer Chemother Pharmacol,1994,35(Suppl): S65-S68.
[10] HANSLADEN D A, WHEELER M A, AHLERI D C, et al. Effect of intravesical treatment of transitional cell carcinoma with bacillus calmette-gueifn and mitromycin Con urinary survinin levels and outcome [J].J Urol,2003,170(1):230-234.
[11] LI X,WANG G,ZHAO J,et al.Antiproliferative effect of beta-elemene in chemoresistant ovarian carcinoma cells is mediated through arrest of the cell cycle at the G2-M phase[J].Cell Mol Life Sci,2005,62(7):894-904.
[12] SCOFFONE C M, CRACCO C M, POGGIO M, et al. Treatment of the pyelocalyceal tumors with laser [J].Arch EspUrol, 2008,61(9):1080-1087.
[13] 武斌,陆向东,李建华,等.卡介苗、羟基喜树碱、表柔比星膀胱内灌注化疗预防膀胱癌术后复发的疗效评价[J].现代泌尿外科杂志,2012,17(6):568-570.
[14] 徐莉英,陶淑娟,张兴中,等.β-榄香烯芳杂环衍生物的合成及体外抗癌活性研究[J]. 中国药物化学杂志,2006 ,16(5):277-280.
[15] 贾本忠,李家富,顾昌世.榄香烯乳治疗膀胱癌的临床观察[J].贵州医药,2002,26(9):810-811.
[16] 王一喆,胡雪君. β-榄香烯治疗晚期非小细胞肺癌的临床应用现状及研究进展[J].现代肿瘤医学,2018,26(10):1643-1646.
[2] 杨璐,刘华伟,李恒平, 等.膀胱灌注预防膀胱肿瘤术后复发和进展[J].现代预防医学,2015,42(8):1526-1530.
[3] SEISEN T, GRANGER B, COLIN P, et al. A Systematic review and meta-analysis of clinicopathologic factors linked to intravesicalrecurrence after radical nephroureterectomy to treat upper tract urothelial carcinoma[J].Eur Urol,2015,67(6):1122-1133.
[4] SEISEN T, PEYRONNET B, DOMINGUEZ-ESCRIG L, et al. Oncologic outcomes of kidney-sparing surgery versus radical nephroureterectomy for upper tract urothelial carcinoma: A systematic review by the EAU non-muscle invasive bladder cancer guidelines panel[J].Eur Urol,2016,70(6):1052-1068.
[5] 赵永顺,吴春明,董斌,等.榄香烯抑制Raf/MEK/ERK信号通路诱导人源胶质瘤U87细胞凋亡[J].实用药物与临床,2011,14(5):365-367.
[6] 李传刚,李墨林,舒晓宏,等.β-榄香烯对人膀胱癌 BIU87 细胞磷脂代谢转换率及细胞脂膜流动性的影响[J].中华医学杂志,2004,84(5):416-417.
[7] LI G, XIE B, LI X, et al. Downregulation of peroxiredoxin-1 by ? β-elemene enhances the radiosensitivity of lung adenocarcinoma xenografts[J]. Oncol Rep, 2015, 33(3):1427-1433.
[8] 张建春,李军,朱峰,等.经尿道膀胱肿瘤电切术后立即腔内灌注及定期灌注吡柔比星预防复发的疗效观察[J].中国医药,2010,5(5):431-432.
[9] UEKADO Y,HIRANO A,SHINKA T,et al.The effects of intravesicalchemoimmunotherapy with epirubicin and bacillus Calmette-Guerin for prophylaxis of recurrence of superficial bladder cancer: a preliminary report [J].Cancer Chemother Pharmacol,1994,35(Suppl): S65-S68.
[10] HANSLADEN D A, WHEELER M A, AHLERI D C, et al. Effect of intravesical treatment of transitional cell carcinoma with bacillus calmette-gueifn and mitromycin Con urinary survinin levels and outcome [J].J Urol,2003,170(1):230-234.
[11] LI X,WANG G,ZHAO J,et al.Antiproliferative effect of beta-elemene in chemoresistant ovarian carcinoma cells is mediated through arrest of the cell cycle at the G2-M phase[J].Cell Mol Life Sci,2005,62(7):894-904.
[12] SCOFFONE C M, CRACCO C M, POGGIO M, et al. Treatment of the pyelocalyceal tumors with laser [J].Arch EspUrol, 2008,61(9):1080-1087.
[13] 武斌,陆向东,李建华,等.卡介苗、羟基喜树碱、表柔比星膀胱内灌注化疗预防膀胱癌术后复发的疗效评价[J].现代泌尿外科杂志,2012,17(6):568-570.
[14] 徐莉英,陶淑娟,张兴中,等.β-榄香烯芳杂环衍生物的合成及体外抗癌活性研究[J]. 中国药物化学杂志,2006 ,16(5):277-280.
[15] 贾本忠,李家富,顾昌世.榄香烯乳治疗膀胱癌的临床观察[J].贵州医药,2002,26(9):810-811.
[16] 王一喆,胡雪君. β-榄香烯治疗晚期非小细胞肺癌的临床应用现状及研究进展[J].现代肿瘤医学,2018,26(10):1643-1646.
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