| 摘要: |
| 目的：探讨艾克佳（Nocardia rubra cell wall skeleton, N-CWS）膀胱灌注治疗对中高危非肌层浸润性膀胱癌(non-muscle invasive bladder cancer，NMIBC)患者经尿道膀胱肿瘤切除(transurethral resection of bladder tumor，TURBT)术后生存质量、远期生存率的影响。方法：回顾性分析2018年10月至2021年5月浙江省三家医院经治的40例TURBT术后经卡介苗芽孢杆菌 (bacillus calmette-guerin，BCG)治疗不耐受的中高危NMIBC患者临床资料，依据治疗方案分为对照组与研究组。对照组接受丝裂霉素膀胱灌注化疗，而研究组采用红色诺卡氏菌细胞壁骨架膀胱灌注治疗。评估两组患者临床疗效，分析对比两组治疗前后肝肾功能、血液学指标、生存质量评分、远期生存率和复发率，统计两组患者治疗过程中出现的不良反应。结果：治疗后研究组红细胞、血小板计数均高于对照组，差异具有统计学意义（P<0.05）。治疗后研究组白细胞高于对照组，但差异无统计学意义（P＞0.05）。治疗后研究组ALT、AST低于对照组，差异具有统计学意义（P<0.05），而肌酐、尿素氮与对照组比较差异无统计学意义（P＞0.05）。与对照组相比，治疗后研究组泌尿系统症状、未来担心、治疗产生问题等生活质量评分低于对照组（P<0.05）。研究组中位无复发生存期（31.1月）高于对照组的（24.5月）（P<0.05）。研究组3年期复发率4.5%（1/22）低于对照组33.3%（6/18）的（χ2=3.864, P=0.049）。两组患者高热、膀胱刺激征、乏力等不良反应发生率比较差异无统计学意义（P>0.05）。结论：针对中高危非肌层浸润性膀胱癌TURBT手术患者采用艾克佳膀胱灌注治疗疗效确切，安全性较好，能够有效提高患者生存质量，延长患者生存期。 |
| 关键词: 红色诺卡氏菌细胞壁骨架 丝裂霉素 非肌层浸润性膀胱癌 卡介苗芽孢杆菌 膀胱灌注 |
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| Real-world study of the effect of Nocardia rubra cell wall skeleton bladder infusion therapy on the long-term survival after TURBT in patients with intermediate and high-risk non-muscle-invasive bladder cancer |
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Hong junhui,Ying haijun,zhang beibei,Xu zhijie,Jiang peng
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1.Tonglu County Traditional Chinese Medicine Hospital;2.Taizhou Cancer Hospital;3.The First Affiliated Hospital of Zhejiang University School of Medicine
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| Abstract: |
| Objective To investigate the effect of Nocardia rubra cell wall skeleton (N-CWS) bladder infusion therapy on the quality of life of transurethral resection of bladder tumor (TURBT) in patients with medium- and high-risk non-muscle invasive bladder cancer (NMIBC) after resection (TURBT). Shadow of long-term survival. Methods A retrospective analysis of the clinical data of 40 patients with intermediate and high-risk non-muscle-invasive bladder cancer (NMIBC) who were intolerant to Bacillus Calmette-Guerin (BCG) treatment after transurethral resection of bladder tumor (TURBT) and were treated in three hospitals in Zhejiang Province from October 2018 to May 2021, and were divided into control group and study group according to the treatment plan. The control group received mitomycin bladder infusion chemotherapy, while the study group was treated with Nocardia rubra cell wall bladder infusion. Liver and kidney function, hematological indexes, quality of life score, long-term survival rate and recurrence rate were analyzed and compared between the two groups before and after treatment, and the adverse reactions of the two groups during treatment were statistically counted. Results After treatment, the red blood cell and platelet counts in the study group were higher than those in the control group, and the difference was statistically significant(P<0.05). After treatment, the leukocytes in the study group were higher than those in the control group, but the difference was not statistically significant(P>0.05). After treatment, the ALT and AST in the study group was lower than that in the control group, and the difference was statistically significant (P<0.05), while none significant differences were found in creatinine and blood urea nitrogen between the study group and the control group (P>0.05). Compared with the control group, the quality of life scores of urinary symptoms, future worries, and treatment problems in the study group were lower than those in the control group (P<0.05). The median recurrence-free survival in the study group (31.1 months) was higher than that in the control group (24.5 months) (P<0.05). The recurrence rate of the study group (4.5%) was lower than that of the control group (33.3%) (χ2=3.864, P=0.049). There was no significant difference in the incidence of adverse reactions such as high fever, bladder irritation, and fatigue between the two groups (P>0.05). Conclusion For patients undergoing TURBT surgery for medium- and high-risk non-muscle-invasive bladder cancer, the treatment with Ekjia bladder infusion has definite efficacy and good safety, which can effectively improve the quality of life and prolong the survival of patients. |
| Key words: Nocardia rubra cell wall skeleton Mitomycin Non-muscle-invasive bladder cancer Bacillus calmette-guerin Intravesical administration |