| Objective:To compare clinical efficacy of intravesical instillation of gemcitabine(GEM)and Bacillus Calmette Guérin(BCG)for high-risk non-muscle invasive bladder cancer.Method: 208 NMIBC patients from the first affiliated hospital of China Medical University underwent transurethral resection of bladder tumor during September 2015?June 2017 are included.All of the patients were certified as high-risk NMIBC without metastasis.Patients are assigned into GEM(n=135) and BCG(n=73)group.Then followed up recurrence?progression and side effects between two groups.Kaplan-Meier is applied in tumor event-free survival rate and life duration.There is significant differences when P<0.05.Results:208 patients are included in the research,male 162 and female 46,single tumor 64,multiple tumor 144 with a 10 months' median follow-up time.There is no significant difference in gender,age and tumor stages.Recurrence rate of BCG group is significantly lower than GEM group(21.9% vs 38.5%,P=0.015),the non-recurrence survival rate is 78.1% and 61.5%.However,there was no significant difference(P=0.257)in tumor progression between GEM(20.0%)group and BCG group(13.7%),the no-progression survival rate is 20.0% and 13.7%;adverse effects of GEM is significantly lower than BCG group(14.1% VS 27.4%,P=0.019).Conclusion:BCG is superior to GEM in preventing recurrence,but there is no significant difference in tumor progression,adverse effects of BCG is higher than GEM group,the bladder irritation symptom and gross hematuria are the most common side effects.Although BCG is more effective in preventing recurrence of high risk NMIBC,the morbidity rate of side effects is high with high price in addition,the basic hospital can't put it into widely use.While GEM can be used as a substitution when unrequested or untolerance of BCG happen.As the development of medicine,more therapies will lead to a better cure of disease. |
PDF Full Text Request