Efficacy Analysis Of Gemcitabine Combined With Cisplatin/loplatin Internal Iliac Artery Chemoembolization In Patients With Advanced Bladder Urothelial Carcinoma With Hemorrhage

Objective:To investigate the clinical efficacy and safety of gemcitabine / cisplatin(GC)and gemcitabine / loplatin(GL)in patients with advanced bladder urothelial carcinoma with hemorrhage.Methods:Between January 2015 and August 2019,50 patients(40 men and 10 women;mean age 75years)underwent internal iliac transcatheter arterial chemoembolization.According to the chemotherapy regimen,the patients were divided into two groups: gemcitabine / cisplatin group(GC,n = 31)and gemcitabine / lobaplatin group(GL,n = 19).The success rate of early and late hemostasis,disease control rate,median survival time and the incidence of adverse events were observed.Results:The hemostasis success rates of the GC and GL groups were 93.5% and 100% in the early stage,58.1% and 47.4% in the late stage,respectively.There was no significant difference in hemostasis success rates between the two groups(P > 0.05).The disease control rate was significantly better in the GC group(71.0%)than in the GL group(42.1%),the difference was statistically significant(P< 0.05),but the median survival Time of the two groups was similar(Log Rank,P > 0.05).Three patients(9.7%)in the GC group had varying degrees of postoperative serum creatinine.One patient(3.2%)died of acute renal failure,and no abnormal renal function occurred in the GL group.During the follow-up period,there were no other treatment-related serious complications.Mild adverse events such as nausea,abdominal pain,hip pain,and fever all disappeared after 3 to 5 days,and the difference was not statistically significant(P > 0.05).Conclusions:In the treatment of advanced bladder urothelial carcinoma patients with hemorrhage,GC regimen can effectively control the disease progression of most patients,and GL regimen is safer in patients with renal insufficiency.