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目的:探讨转移性膀胱癌患者采用吉西他滨联合顺铂方案进行化疗的效果。方法:化疗第1,8,15天,吉西他滨1 000 mg/m2静脉滴注;化疗第1~3天,顺铂30 mg/m2静脉滴注。28 d为1个疗程。化疗前1~3 d,每日3 000~4 000 ml水化。化疗前30 min静脉推注地塞米松10 mg、肌内注射苯海拉明40 mg。化疗第1~3天,分别于化疗前15min、化疗后4 h、化疗后8 h静脉推注昂丹司琼8 mg以预防消化道反应。对化疗后Ⅱ度以上粒细胞缺乏者给予集落刺激因子升白细胞治疗。化疗3个疗程后进行疗效评价、KPS评分,并观察化疗不良反应。结果:CR 8例(15.3%),PR 25例(48.2%),SD 13例(25.0%),PD 6例(11.5%),治疗总有效率为63.5%。治疗后临床症状较前明显缓解和减轻43例(82.7%),KPS评分相应提高10~20分;6例(11.5%)患者因化疗副反应较重、病灶增大,KPS评分下降1~20分。主要化疗毒副作用为骨髓抑制、血小板减少、消化道反应,未出现严重的心、肺、脑、肝、肾、皮肤等脏器毒性及过敏反应。结论:吉西他滨联合顺铂化疗方案治疗转移性膀胱癌安全、有效。
Objective: To investigate the effect of gemcitabine plus cisplatin chemotherapy in patients with metastatic bladder cancer. Methods: The 1st, 3rd and 15th days of chemotherapy and the intravenous injection of Gemcitabine 1 000 mg / m2 on the 1st, 3rd and 3rd days of chemotherapy were intravenously dripped with cisplatin 30 mg / m2. 28 d for a course of treatment. 1-3 days before chemotherapy, daily 3 000 ~ 4 000 ml hydration. 30 minutes before chemotherapy, intravenous dexamethasone 10 mg, intramuscular injection of diphenhydramine 40 mg. Chemotherapy 1 to 3 days, respectively, 15min before chemotherapy, 4 h after chemotherapy, 8 h after chemotherapy, intravenous infusion of ondansetron 8 mg to prevent digestive tract reactions. After chemotherapy Ⅱ degree or more granulocytes were given colony stimulating factor leukocyte therapy. After 3 courses of chemotherapy, the curative effect evaluation, KPS score, and the adverse reactions of chemotherapy were observed. Results: CR 8 cases (15.3%), PR 25 cases (48.2%), SD 13 cases (25.0%), PD 6 cases (11.5%), the total effective rate was 63.5%. After treatment, 43 cases (82.7%) were relieved and relieved of clinical symptoms, and KPS score increased by 10 ~ 20 points. Six patients (11.5%) had worse side effects and increased lesions, KPS scores decreased by 1 to 20 Minute. The main side effects of chemotherapy for bone marrow suppression, thrombocytopenia, gastrointestinal reactions, no serious heart, lung, brain, liver, kidney, skin and other organ toxicity and allergic reactions. Conclusion: Gemcitabine combined with cisplatin chemotherapy in the treatment of metastatic bladder cancer is safe and effective.