Comparison Of The Efficacy Of Gemcitabine And Pirubicin In Patients With Non-muscular Invasive Bladder Cancer After TURBT Surgery

Objective:To Compare the efficacy and safety of gemcitabine and pirubicin in the postoperative perfusion therapy of non-muscular-invasive bladder cancer with TURBT.Methods:A retrospective analysis was made on 99 patients with non-muscular invasive bladder cancer who underwent TURBT in the Department of Urology of Yijishan Hospital of Southern Anhui Medical College from June 2013 to June 2018.Regular bladder instillation was performed after operation,and the drugs were gemcitabine and pirarubicin respectively.According to the use of perfusion drugs,the patients were divided into gemcitabine group and pirarubicin group.During the follow-up of 2 years,the tumor recurrence rate within one year,the tumor recurrence rate within two years and the adverse reactions(hematuria,cystitis,bladder irritation,suprapubic discomfort and gastrointestinal reaction)were recorded between the two groups.Statistical analysis was used to analyze whether there was any difference.Results:This study included 99 patients with NMIBC,including 49 patients in gemcitabine group and 50 patients in pirarubicin group.There was no death during the two-year follow-up.The average age of all patients was 54.58 years old,the median age was 55 years old,the maximum was 65 years old and the youngest was 39 years old.65 cases were Ta stage,34 cases were T1 stage,65 cases were low grade,34 cases were high grade.The diameter of tumor < 3cm was 77 cases,≥ 3cm was 22 cases,single tumor was 79 cases,multiple tumor was 20 cases.There was no significant difference in sex,age,tumor stage,tumor grade,tumor size and tumor number between the two groups(p > 0.05).In gemcitabine group,2 cases relapsed within one year,the recurrence rate was 4.1%(2/49),3 cases recurred within two years,and the recurrence rate was 6.1%(3/49).In pirarubicin group,10 cases recurred within one year,the recurrence rate was 20.0%(10/50),and 14 cases recurred within two years,and the recurrence rate was 28%(3/49).There is statistical significance between the two groups(p < 0.05).There is significant difference in kaplan-meier recurrence survival curve between the two groups(?2=6.877,p=0.009).In gemcitabine group,patients with hematuria,bladder irritation,cystitis,suprapubic discomfort and gastrointestinal reaction accounted for 14.3%,18.4%,6.1%,6.1% and 4.1%,respectively.Patients with hematuria,bladder irritation,cystitis,suprapubic discomfort and gastrointestinal reactions in the pirarubicin group accounted for 22.0%(11/50),36.0%(18/50),20.0%(10/50),20.0%(10/50)and 20.0%(10/50)respectively.All patients had no serious adverse reactions and could be relieved or improved after treatment.There is no significant difference in hematuria between the two groups(p > 0.05),but there is significant difference in bladder irritation sign,cystitis,suprapubic discomfort and gastrointestinal reaction between the two groups(p < 0.05).Conclusion:After NMIBC,gemcitabine group was more effective in preventing recurrence than pirarubicin,and gemcitabine group performed better in terms of adverse reactions after perfusion,so it could be considered that gemcitabine was safer.