分剂量顺铂新辅助化疗用于肌层浸润性膀胱癌患者的疗效与安全性

打开文本图片集

ABSTRACT：ObjectiveTo compare the eficacyand safety of gemcitabinecombined with conventional-dose cisplatin （ 70mg/m2 ，day 2）versus split-dose cisplatin （ 35mg/m2 ，days 1 and 8）in neo-adjuvant therapy for muscle-invasive bladder cancer （MIBC）.Methods The clinical data of 33 MIBC patients receiving（gemcitabine + cisplatin，GC）-based neoadjuvant chemotherapyintheDepartmentof Urologyof Xinhua Hospital，duringJan.202landAug.2024 wereretrospectivelyanalyzed， including 18（54.5% ）patients treated with a conventional-dose regimen（GC group），and 15（ 45.5% ）patients treated with a split-dose egimen（GCs group）.Theeficacy endpoints andincidence/severityof adversereactions werecompared between the two groups.ResultsBaseline characteristics were well-balanced between the two groups （ P>0.05 ）.No significant differences were observed in the complete response rate（CR： 33.3% vs. 22.2% ），objective response rate（ORR： 66.7% vs. 61.1% ），or disease control rate（DCR： 80.0% vs. 88.9% ）between the GCs and GC groups （ P>0.05） . The GCs group exhibited a significantly lower incidence of chemotherapy-related renal injury （6.7% vs. 38.9% P<0.05） ，while the occurrence of other adverseeventswascomparable between thetwogroups.Notably，theGCsgroup demonstrated significantlyattenuated nephrotoxicity，as evidenced by markedly smaller changes in estimated glomerular filtration rate [eGFR： （4.5±4.7）%ν. S （18.0±11.8）%] and serum creatinine [SCr （5.7±5.6）%ν S. （20.2±19.5）%] compared to the GC group （ P<0.05） ： ConclusionCompared with the conventional-dose regimen，the split-doseregimen maintains equivalent clinical eficacyof GC-based neoadjuvantchemotherapywhilesignificantlyreducingchemotherapy-relatednephrotoxicity，thereby providing MIBC patients with a safer therapeutic option.

KEY WORDS： muscl-einvasive bladdercancer;gemcitabine;cisplatin;neoadjuvantchemotherapy;split-dose administration; nephrotoxicity

摘要：目的比较吉西他滨联合常规剂量 （70mg/m2 ，第2天）或分剂量 （35mg/m2 ，第1、8天）顺铂方案在肌层浸润性膀胱癌（MIBC）患者新辅助化疗（NAC）中的疗效和安全性，为临床治疗决策提供参考。（剩余11613字）