Clinical Analysis Of Gemcitabine,epirubicin And Sequential Intravesical Perfusion After Non-muscle Invasive Bladder Cancer

Objective The research was designed to compare the clinical efficacy of gemcitabine(GEM),epirubicin(EPI)and sequential intravesical perfusion of bladder after non-muscle invasive bladder cancer(NMIBC).The recurrence,progression and adverse reactions of bladder cancer after three different bladder irrigation regimens were recorded.It is to provide a clinical reference for the continued treatment of NMIBC patients after surgery.Methods 98 cases of non-muscle invasive bladder cancer hospitalized from January 2014 to February 2017 in Urology of Qinghai Provincial People's Hospital were divided into three groups according to different perfusion methods,including gemcitabine group of 32 cases that gemcitabine chemotherapy was used in the bladder;epirubicin group of 36 cases with epirubicin used;sequential perfusion group of 30 cases with gemcitabine used at first and then epirubicin,after alternating.Three groups of total perfusion treatment time were all one year.The curative effects of three different bladder irrigation schemes were compared and analyzed,including the recurrence,progression and adverse reactions of bladder cancer after operation.Results(1)The recurrence rate of bladder cancer of sequential group within one year(6.67%)was compared with that of gemcitabine group(31.25%)and epirubicin group(30.56%),and the difference was statistically significant(P<0.05);(2)The progression rate of bladder cancer of the sequential group within one year(3.33%)was not significantly different from that of the gemcitabine group(6.25%)and epirubicin group(5.56%)(P>0.05);(3)Adverse reactions: The incidences of bladder irritation in sequential group,gemcitabine group and epirubicin group were 6.67%,31.25% and 27.78% respectively,with significant differences among the three groups(P<0.05);the incidence of gross hematuria and fever was not statistically different among the three groups(P> 0.05).Conclusions Sequential combination of gemcitabine and epirubicin is superior to single drug in preventing the recurrence of bladder cancer.Sequential combination of two drugs on tumor cell killing effect is more effective to reduce the recurrence rate of bladder cancer within one year,and less symptoms of bladder irritation,but it can not effectively improve the postoperative progress of bladder cancer.