目的：观察和探讨吉西他滨、顺铂（GC）方案新辅助化疗治疗肌层浸润性膀胱癌（MIBC）患者的临床疗效及安全性。方法回顾性分析MIBC患者69例，予以吉西他滨800～1000mg/m2，第1、8、15天静脉滴注；顺铂25mg/m2，第1～3天静脉滴注的3～4个疗程新辅助化疗。化疗结束后依据患者病情选择不同手术方式治疗，随访记录不良反应，比较新辅助化疗前后肿瘤最大径和最小径的差异。结果行GC方案新辅助化疗的平均疗程为3．5个，完全应答率27．9％（19/68），部分应答率22．1％（15/68）；临床获益率79．4％（54/68）；疾病进展率20．6％（14/68）。随访期4～55个月，中位随访期20个月，中位应答期16个月。化疗后肿瘤最大径及最小径明显减小，差异均具有统计学意义（P＜0．05）。主要毒性反应为骨髓抑制及消化道反应是，未出现化疗相关严重不良反应所致化疗相关性死亡。结论在短期内，3～4个疗程GC方案新辅助化疗可获得较高的应答率，显著减小肿瘤体积，具有可靠的安全性及耐受性。%Objectives This study was conducted to evaluate the effect,toxicity,and tolerability of the treat-ment of neoadjuvant gemcitabine and cisplatin (GC)chemotherapy then followed by surgery in patients with MI-BC. Methods We retrospective analyzed 69 patients who had MIBC. The GC neoadjuvant chemotherapy was giv-en by Gemcitabine (800~1000mg/m2 )on days 1,8,and 15;Cisplatin (25mg/m2 )on days 1,2,and 3. Af-ter that,the patients were underwent the proper surgical approaches for the next treatment according to their con-dition. We followed up and analyzed of diameter (maximum and minimum)of tumors which under neoadjuvant chemotherapy. Results The average cycle of the GC neoadjuvant chemotherapy was 3. 5,CR rate was 27. 9%(19/68 ),PR rate was 22 . 1%(15/68 ),clinical benefit rate was 79 . 4%(54/68 ),PD rate was 20 . 6%(14/68). The follow-up period was 4~55 months,the median follow-up period was 20 months and the median response period was 16 months. The difference in average maximum and minimum diameter between the two groups (before and after the treatment)were both statistically significant (P<0. 05). The main toxicity reactions were myelosuppression and gastrointestinal toxicities. Toxicities of chemotherapy were manageable with no toxic deaths. Conclusions In the short term,three to four 28-day cycles of GC neoadjuvant chemotherapy obtains high response rate and significantly reduces tumor volume which shows well tolerated in clinical and is a safe neoadjuvant chemotherapy.
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