Effect Analysis Of Gemcitabine And Epirubicin In The Treatment Of Non-Muscular Invasive Bladder Neoplasms

Research background: Bladder cancer is one of the most common cancers in the urinary system,of which non-invasive bladder cancer(NMIBC)is predominant,accounting for more than 70% of all bladder cancers.And the postoperative tumor recurrence rate is high,and even progress to invasive bladder cancer.Therefore,intravesical instillation of anti-tumor drugs was used for adjuvant therapy after surgical treatment.At present,there are a variety of perfusion drugs in clinical practice,of which the commonly used drugs are pirarubicin,epirubicin,mitomycin and so on.However,the quality of life of patients is low due to the variable sensitivity of different drugs and many adverse reactions.At present,there is an urgent need for a treatment regimen with good efficacy,good safety and economy.A recent study reported that the use of gemcitabine combined with chemotherapy for metastatic bladder cancer was effective and popular with more and more clinicians due to the less toxic side effects of gemcitabine combined with chemotherapy.Gemcitabine has also been used in combination in the treatment of extensive and T4 refractory tumors,but the dosage and drug concentration of gemcitabine vary.This study will therefore use different concentrations of gemcitabine for perfusion therapy.Objective:In this study,we investigated the administration of epirubicin and different concentrations of gemcitabine instillation after transurethral resection of bladder tumor(TURBT)in patients with non-invasive bladder tumors.The recurrence,adverse reactions and quality of life of the three groups were observed to provide a reference basis for clinical treatment.Methods:In this study,patients diagnosed with bladder cancer by examination in Tongliao Hospital from July 2018 to March 2020 were screened,TURBT was performed for patients who met the criteria,and intravesical instillation therapy was performed for patients with postoperative NMIBC.They were randomly divided into epirubicin group,gemcitabine low-dose group,and gemcitabine high-dose group according to different intravesical drugs.The tumor recurrence,adverse reactions and quality of life during intravesical therapy in all patients were statistically analyzed by means of clinical data collection and telephone follow-up,and the collected data were analyzed and compared using the statistical software SPSS 20.0.Results:(1)Recurrence was as follows: The tumor recurrence rate within 1 year was 17.64%(6/34),8.82%(3/34),and 6.67%(2/30)in the epirubicin,gemcitabine low-dose,and gemcitabine high-dose groups,respectively.The recurrence rate within 1 year in the three groups of patients with non-invasive bladder cancer was significantly different between the epirubicin group and the gemcitabine low-dose group(P < 0.05).There was a significant difference in the recurrence rate between the epirubicin group and the gemcitabine high-dose group(P < 0.05).However,there was no significant difference in the recurrence rate between the gemcitabine low-dose group and the gemcitabine high-dose group(P > 0.05).(Fig.2)Adverse reactions: The incidence of adverse reactions was 32.3%(11/34),20.0%(6/30),and17.6%(6/34)in the epirubicin,gemcitabine high-dose,and gemcitabine low-dose groups,respectively.The incidence of adverse reactions during perfusion was compared among the three groups.There was significant difference in the incidence of adverse reactions between the epirubicin group and the gemcitabine low-dose group(P < 0.05).There was no significant difference between the gemcitabine low-dose group and the gemcitabine high-dose group(P >0.05).The incidence of adverse reactions in the epirubicin group was significantly different from that in the gemcitabine high-dose group(P < 0.05).3)Comparison of quality of life:There was significant difference in quality of life between the epirubicin group and the gemcitabine low-dose group(P < 0.05).There was no significant difference between the gemcitabine low-dose group and the gemcitabine high-dose group(P > 0.05).There was a significant difference in the quality of life between the epirubicin group and the gemcitabine high-dose group(P < 0.05).4)Comparison of treatment costs: The treatment cost was lower in the gemcitabine low-dose group compared with the gemcitabine low-dose group,and the difference was statistically significant(P < 0.05).Compared with the gemcitabine high-dose group,the gemcitabine low-dose group had a lower treatment cost,and the difference was statistically significant(P < 0.05).The cost of treatment was lower in the epirubicin group compared with the gemcitabine high-dose group,and the difference was statistically significant(P < 0.05).Conclusion:1.For patients with non-invasive bladder cancer,intravesical gemcitabine is more effective than epirubicin in preventing postoperative tumor recurrence after TURBT.2.the incidence of adverse reactions with intravesical gemcitabine was lower than that in the epirubicin group.3.Gemcitabine for intravesical therapy has a higher quality of life than epirubicin.4.For NMIBC,the use of gemcitabine(1000 mg)perfusion can reduce the recurrence rate and has a low cost of treatment,which has a price advantage.