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紫杉醇联合卡铂作为晚期尿路上皮癌二线化疗方案用于对吉西他滨和顺铂一线治疗耐药患者的临床疗效

Clinical outcome of paclitaxel and carboplatin as second-line chemotherapy for advanced urothelial carcinoma resistant to first-line therapy with gemcitabine and cisplatin.

作者信息

Terakawa Tomoaki, Miyake Hideaki, Yokoyama Naoki, Miyazaki Akira, Tanaka Hiroyuki, Inoue Takaaki, Fujisawa Masato

机构信息

Division of Urology, Hyogo Cancer Center, Akashi, Japan.

出版信息

Urol Int. 2014;92(2):180-5. doi: 10.1159/000354149. Epub 2013 Nov 13.

Abstract

OBJECTIVE

The objective was to investigate the efficacy and tolerability of combined therapy with paclitaxel and carboplatin (TC) in patients with advanced urothelial carcinoma after the failure of first-line chemotherapy with gemcitabine and cisplatin (GC).

PATIENTS AND METHODS

This was a retrospective study including a total of 16 patients with advanced urothelial carcinoma who showed evidence of progressive and/or recurrent disease after first-line therapy with GC and subsequently received second-line chemotherapy consisting of paclitaxel (175 mg/m(2)) and carboplatin (area under the curve 5). TC therapy was repeated every 3 weeks and was continued until disease progression or intolerable toxicity was observed.

RESULTS

The baseline patient characteristics were rather favorable; only 3 of 16 patients had liver metastases and 7 patients had an Eastern Cooperative Oncology Group performance status of 0. Of these, response to TC therapy was achieved in 5 (31.3%), including 2 with complete and 3 with partial response. The median progression-free and overall survival times in the 16 patients were 7.9 and 17.3 months, respectively.

CONCLUSIONS

TC therapy appeared to show modest activity with acceptable tolerability in patients refractory to GC therapy; therefore, TC chemotherapy might be considered as an alternative option as a second-line regimen for advanced urothelial carcinoma following GC therapy.

摘要

目的

探讨在吉西他滨和顺铂(GC)一线化疗失败后,紫杉醇联合卡铂(TC)治疗晚期尿路上皮癌患者的疗效和耐受性。

患者与方法

这是一项回顾性研究,共纳入16例晚期尿路上皮癌患者,这些患者在接受GC一线治疗后出现疾病进展和/或复发证据,随后接受由紫杉醇(175mg/m²)和卡铂(曲线下面积为5)组成的二线化疗。TC治疗每3周重复一次,持续进行直至观察到疾病进展或出现无法耐受的毒性。

结果

患者基线特征较为良好;16例患者中仅3例有肝转移,7例东部肿瘤协作组体能状态评分为0。其中,5例(31.3%)对TC治疗有反应,包括2例完全缓解和3例部分缓解。16例患者的无进展生存期和总生存期的中位数分别为7.9个月和17.3个月。

结论

TC治疗在GC治疗难治的患者中似乎显示出适度活性且耐受性可接受;因此,TC化疗可被视为GC治疗后晚期尿路上皮癌二线治疗方案的替代选择。

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