The short-term efficacy and prognosis analysis of intensity-modulated radiotherapy with synchronous chemotherapy of gemcitabine plus pirarubicin hyperthermic perfusion chemotherapy in the treatment of elderly patients with advanced bladder cancer
HUANG Yichao;LIU Yunjun;LU Xiaoling;WEN Jian;GAO Yanfeng;Department of Oncology, Maoming People's Hospital;
Objective To investigate the short-term efficacy and prognosis of intensity-modulated radiotherapy(IMRT) combined with gemcitabine chemotherapy plus pirarubicin hyperthermic perfusion chemotherapy in the treatment of elderly patients with advanced bladder cancer. Method The clinical data of 118 patients with advanced bladder cancer were retrospectively analyzed and assigned as study group and control group, according to respective different therapies administered, each included 59 patients. The control group was treated with IMRT alone, while the study group was given IMRT in combination with synchronous gemcitabine plus pirarubicin hyperthermic perfusion chemotherapy.The short-term efficacy and occurrence of adverse reactions in the two groups were compared and analyzed, and the prognostic factors of survival were investigated. Result The overall response rate(RR) and the disease control rate(DSR) of the study group were higher than those of the control group in 1 month after treatment, with significant difference observed(P0.05). The incidence of adverse reactions in the two groups was similar, the difference was of no statistical significance(P0.05), and so did the overall incidence of adverse reactions between the two groups(P0.05), none had any case of serious adverse events at grade four; in study group, the median overall survival(OS) was 18.58 months(95%CI:16.55-20.59), while that of control group was 14.23 months(95%CI: 12.16-16.29), so and median OS was better in study group compared with control group(P=0.042). Multivariate stepwise Cox regression analysis showed that, poor or moderate histological grading, with lymph node metastasis near the bladder, and large tumor diameter were independent prognostic risk factors in elderly patients with advanced bladder cancer(P0.05). Conclusion IMRT and gemcitabine combined with pirarubicin hyperthermic perfusion chemotherapy is effective in the treatment of elderly patients with advanced bladder cancer, the combined therapy can effectively improve the short-term efficacy, with no serious adverse reaction of grade four, which is a potentially applicable therapy for elderly patients with advanced bladder cancer.
【CateGory Index】： R737.14