Hirata Takeshi, Hanamoto Masanori, Ogura Kazuma, Hayashi Nobuki, Takamura Kosuke, Edamura Kohei, Ebara Shin, Saika Takashi
Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima 730-8518,
Acta Med Okayama. 2018 Apr;72(2):175-179. doi: 10.18926/AMO/55858.
There is no standard second-line or salvage treatment for advanced urothelial carcinoma (UC). Here we investigated the efficacy and safety of gemcitabine, cisplatin, and paclitaxel (GCP) combination chemotherapy as salvage chemotherapy for advanced UC. We retrospectively analyzed the cases of 23 patients with advanced UC who showed progression or recurrence after cisplatin-based chemotherapy. Gemcitabine (1000 mg/m2), and paclitaxel (80 mg/m2) were administered on days 1 and 8. Cisplatin (70 mg/m2) was administered on day 1. The 3-week cycle regimen was repeated until disease progression if it had no intolerable toxicity. The overall response rate was 61% (95%CI, 41-78%). The median overall survival and progression-free survival times were 14 months and 5.5 months, respectively. Of the already known risk factors of chemotherapy for advanced UC, only the performance status was a prognostic factor for OS. Overall, 16 of the 23 patients (70%) experienced grade 3/4 toxicities, and no fatal adverse events were observed. GCP therapy was a promising option as second-line or salvage therapy for advanced UC.
晚期尿路上皮癌（UC）尚无标准的二线或挽救治疗方案。在此，我们研究了吉西他滨、顺铂和紫杉醇（GCP）联合化疗作为晚期UC挽救化疗的疗效和安全性。我们回顾性分析了23例晚期UC患者的病例，这些患者在基于顺铂的化疗后出现进展或复发。吉西他滨（1000 mg/m²）和紫杉醇（80 mg/m²）于第1天和第8天给药。顺铂（70 mg/m²）于第1天给药。如果没有不可耐受的毒性，则重复3周的周期方案，直至疾病进展。总缓解率为61%（95%CI，41-78%）。中位总生存期和无进展生存期分别为14个月和5.5个月。在晚期UC化疗已知的风险因素中，只有体能状态是总生存期的预后因素。总体而言，23例患者中有16例（70%）发生3/4级毒性反应，未观察到致命不良事件。GCP治疗作为晚期UC的二线或挽救治疗是一种有前景的选择。
