[Combination chemotherapy of urothelial cancer with cisplatin, cyclophosphamide, doxorubicin and peplomycin: treatment of advanced cases and adjuvant chemotherapy after radical operation].

Cisplatin, doxorubicin, cyclophosphamide and peplomycin have been used in combination for urothelial cancer. Doxorubicin 30-40 mg/m2 and cyclophosphamide 300-400 mg/m2 were administered on day 1, cisplatin 12-15 mg/m2 daily for 5 days and peplomycin 4-6 mg/m2/day by continuous infusion for 5 days. Courses were given at 3-4-weekly intervals in principle. Eight patients with measurable locally advanced or metastatic disease were treated with this protocol, and four achieved partial remission (objective response 50%). None of the four patients with locally advanced disease showed any response, (three no change, one progressive disease). Another eight patients were treated with adjuvant chemotherapy after radical surgery. Of the four patients with high-grade (G3) and high-stage (pT3b-pT4) bladder cancer, three relapsed 7-14 months after surgery, leaving one who still remains disease-free after 8 months. These preliminary results seem to indicate that our protocol is insufficient for adjuvant chemotherapy after radical surgery for high-grade and high-stage urothelial cancer.