Ito Hideaki, Aoki Yoshitaka, Oyama Nobuyuki, Miwa Yoshiji, Akino Hironobu, Yokoyama Osamu
Dept. of Urology, Faculty of Medical Science, University of Fukui, Japan.
Gan To Kagaku Ryoho. 2011 Mar;38(3):481-4.
The objective of this study was to evaluate the efficacy and toxicity of combination chemotherapy with paclitaxel, carboplatin and gemcitabine in patients with advanced urothelial carcinoma, who have received prior cisplatin-based chemotherapy. Eligible patients had pathologically proven measurable metastatic urothelial carcinoma. Between April 2005 and May 2009, 8 patients with a mean age of 7 0 years were treated every 3 weeks with paclitaxel (200 mg/m² on day 1), carboplatin (AUC= 5/body on day 1) and gemcitabine (800 mg/m² on day 1 and 8). A total of 4 0 (median 4) cycles were administered. None of the 8 patients achieved a complete response(CR), but 3 patients (37. 5%) achieved a partial response (PR) and 3 were stable with the disease(SD). The median overall survival time and the median progression-free survival time were 8. 0 and 4. 5 months, respectively. Grade 4 hematological toxicities included neutropenia in 6 cycles (15. 0%), thrombocytopenia in 8 cycles (20. 0%) and anemia in 11 cycles (27. 5%). Three of the 8 patients had febrile neutropenic episodes, and no toxic death was observed. Our results suggest that the combination chemotherapy of paclitaxel, carboplatin and gemcitabine was effective, and an acceptable treatment for patients with advanced urothelial carcinoma who have received prior cisplatin-based chemotherapy.
本研究的目的是评估紫杉醇、卡铂和吉西他滨联合化疗对既往接受过以顺铂为基础化疗的晚期尿路上皮癌患者的疗效和毒性。符合条件的患者经病理证实有可测量的转移性尿路上皮癌。2005年4月至2009年5月期间，8名平均年龄为70岁的患者每3周接受一次治疗，方案为紫杉醇（第1天200mg/m²）、卡铂（第1天AUC = 5/体表面积）和吉西他滨（第1天和第8天800mg/m²）。共给予40（中位数4）个周期的治疗。8名患者中无一例达到完全缓解（CR），但3例患者（37.5%）达到部分缓解（PR），3例病情稳定（SD）。中位总生存时间和中位无进展生存时间分别为8.0个月和4.5个月。4级血液学毒性包括6个周期（15.0%）出现中性粒细胞减少、8个周期（20.0%）出现血小板减少和11个周期（27.5%）出现贫血。8名患者中有3例发生发热性中性粒细胞减少症，未观察到毒性死亡。我们的结果表明，紫杉醇、卡铂和吉西他滨联合化疗是有效的，对于既往接受过以顺铂为基础化疗的晚期尿路上皮癌患者是一种可接受的治疗方法。
