Effect Of Intravesical Instillation Of Epirubicin,gemcitabine And Pirarubicin On Recurrence And Progression Of NMIBC

Objectives:Compare intravesical instillation regimens of epirubicin,gemcitabine,and pirarubicin to influence tumor recurrence,progression and adverse reactions after NMIBC,and to guide and optimize clinical treatment plans.Methods:(1)A total of 315 middle and high-risk patients with pathologically confirmed NMIBC who were admitted to our hospital and Wanning People’s Hospital from May 2015 to May 2020 were selected.(2)According to different perfusion methods,they were divided into epirubicin group(51 intermediate-risk cases,51high-risk cases),gemcitabine group(51 intermediate-risk cases,55 high-risk cases),and pirarubicin group(52 intermediate-risk cases,55 high-risk cases).(3)General medical records such as age,gender,tumor diameter,tumor number,tumor grade,tumor stage,fever,hematuria,and gastrointestinal reactions after bladder instillation were collected.(4)Theχ~2test was used to compare the differences in medical records and recurrence rates;Kaplan-Meier plotted survival curves,and Log-rank compared the differences in survival curves;Logistic regression was used to analyze the risk factors for tumor recurrence.Results:(1)There was no statistical difference in the general medical records of the three groups of patients(P>0.05);(2)There was no statistical difference in the1-year and 2-year tumor recurrence rates of intermediate-risk NMIBC(P>0.05);the1-year and 2-year tumor recurrence rates in the gemcitabine group were significantly lower than the pirarubicin group(P<0.05),others have no statistical differences(P>0.05).(3)There was no statistical difference in the 2-year recurrence-free survival curve of intermediate-risk NMIBC(P>0.05);among high-risk NMIBC,the 1-year and 2-year recurrence-free survival curves of gemcitabine group were significantly higher than those of pirarubicin group(P<0.05),and there was no statistical difference between the other groups(P>0.05).(4)There was no significant difference in adverse reactions among the three groups during intravesical instillation(P>0.05).(5)Age and tumor stage were the risk factors for the recurrence of intermediate-risk and high-risk NMIBC,which were positively correlated(P<0.05).Conclusions:(1)In high-risk NMIBC patients,the 2-year recurrence free survival rate of gemcitabine intravesical instillation is higher than that of pirarubicin and epirubicin,and the recurrence rate is lower,so gemcitabine is the first choice for treatment.(2)Age and tumor stage are risk factors for NMIBC recurrence.