Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, Turkey,
Clin Transl Oncol. 2014 Jan;16(1):91-5. doi: 10.1007/s12094-013-1047-8. Epub 2013 Apr 25.
We aimed to determine the efficacy and the toxicity of low dose weekly gemcitabine with radiation therapy in medically unfit muscle-invasive bladder cancer patients.
Twenty-six patients were included into the retrospective analysis. Weekly gemcitabine was administered 75 mg/m(2) with a median dose of 63 Gy radiation therapy. Clinical target volume was defined as the urinary bladder only in conformal treatment planning.
Median follow-up was 51 months (range 14-118 months). Complete response rate was 62.5 %. The 5-year local progression-free survival, disease-specific survival and overall survival rates were 40.6, 59.5 and 58.5 %, respectively. Concurrent chemotherapy was continued in 80.7 % of patients without any interruption. Gemcitabine was stopped due to grade 3 thrombocytopenia (n = 1), cardiac angina (n = 1), chronic obstructive pulmonary disease exacerbation (n = 1) or patients' reluctance (n = 2).
Low dose weekly gemcitabine with concurrent radiotherapy is a tolerable regimen and have comparable outcomes with platinum-based combined treatments in muscle-invasive bladder cancer. Prospective randomized trials can help in understanding the safety and efficacy of this treatment specially in medically unfit patients.
我们旨在确定低剂量每周吉西他滨联合放射治疗在不适合接受医学治疗的肌层浸润性膀胱癌患者中的疗效和毒性。
26 例患者被纳入回顾性分析。每周给予吉西他滨 75mg/m²，中位剂量为 63Gy 放射治疗。临床靶区仅在适形治疗计划中定义为膀胱。
中位随访时间为 51 个月（范围 14-118 个月）。完全缓解率为 62.5%。5 年局部无进展生存率、疾病特异性生存率和总生存率分别为 40.6%、59.5%和 58.5%。80.7%的患者无中断继续进行同期化疗。由于血小板减少症 3 级（n=1）、心绞痛（n=1）、慢性阻塞性肺疾病恶化（n=1）或患者不愿（n=2），停止使用吉西他滨。
低剂量每周吉西他滨联合放射治疗是一种可耐受的方案，在肌层浸润性膀胱癌中的疗效与铂类联合治疗相当。前瞻性随机试验可以帮助了解这种治疗方法的安全性和疗效，特别是在不适合接受医学治疗的患者中。
