중간 및 고위험군 표재성 방광암에서 Bacillus Calmette-Guerin(BCG)와 병합한 Gemcitabine 방광 내 주입요법의 초기 경험
Initial Experiences of Intravesical Gemcitabine Instillation Followed by Bacillus Calmette-Guerin(BCG) Therapy for Treating Intermediate or High Risk Patients with Superficial Bladder Cancer
김종욱, 윤덕기, 조대연, 여정균, 박홍석,
소속 상세정보
김종욱 ( Kim Jong-Wook )
고려대학교 의과대학 비뇨기과학교실
윤덕기 ( Yoon Duck-Ki )
고려대학교 의과대학 비뇨기과학교실
조대연 ( Cho Dae-Youn )
고려대학교 의과대학 비뇨기과학교실
여정균 ( Yeo Jeong-Kyun )
고려대학교 의과대학 비뇨기과학교실
박홍석 ( Park Hong-Seok )
고려대학교 의과대학 비뇨기과학교실
KMID : 0358320080490040313
Abstract
Purpose : To investigate the safety and the efficacy of intravesical gemcitabine therapy, we prospectively studied intravesical gemcitabine instillation followed by Bacillus Calmette-Guerin(BCG) instillation for treating the patients who suffer from superficial bladder cancer, and the above method was then compared with conventional BCG instillation.
Materials & Methods : Between May 2005 and April 2007, a total of 84 patients were divided into Group I: the patients were treated with a 2-week course of gemcitabine(1,000mg/50ml, 2,000mg/50ml) followed by a conventional 6-week course of BCG, and Group II: the patients were treated by BCG instillation only. Gemcitabine was instilled immediately within 6 hours after complete trans-urethral resection of the bladder tumor (TURBT) and then this was repeated one week later. BCG instillation was started 2 weeks after TURBT. The complications, recurrence rates, progression rates and recurrence-free period(RFP) were analyzed in both groups.
Results : The treatment was well tolerated in all the patients. Most of the complications were self-limiting, and there was no significant difference between the two groups(p=0.379). The recurrence rates of the two groups were 25.6% and 26.7%, respectively(p=0.899). Yet the recurrence-free period(RFP) was significantly longer in Group I(p=0.021). The progression rates of the two groups were 2.6% and 6.7%, respectively(p=0.620).
Conclusion : Intravesical gemcitabine instillation showed the effect to prolong the recurrence-free period for patients with superficial bladder cancer. Further long-term study will be needed. (Korean J Urol 2008;49: 313-319)
키워드
Gemcitabine; Bladder cancer; Intravesical instillation
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