University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
University of Rochester Medical Center, Rochester, New York, USA.
Oncologist. 2019 May;24(5):688-690. doi: 10.1634/theoncologist.2018-0561. Epub 2019 Feb 6.
Neoadjuvant cisplatin-based chemotherapy (NAC; 70 mg/m) is standard of care for muscle-invasive bladder carcinoma (MIBC). Many patients (pts) cannot receive cisplatin because of renal impairment, and administration of cisplatin 35 mg/m on day 1 + 8 or 1 + 2 (i.e., split schedule) is a commonly used alternative. In this retrospective analysis, we compared complete (pT0) and partial (<pT2) pathologic response rates between split schedule (SS) and conventional schedule (CS) pts, after 1:1 matching on chemotherapy regimen, number of cycles, tumor histology, and clinical stage. Eighty matched pts were identified. pT0 rates were 17.5% (95% confidence interval [CI], 7%-33%) and 32.5% (95% CI, 19%-49%) in SS and CS cisplatin pts, respectively ( = .21), corresponding to an odds ratio for pT0 of 0.45 (95% CI, 0.16-1.31) with SS cisplatin. Split schedule cisplatin was associated with numerically but not statistically significant lower pathologic response rates relative to full dose.
新辅助顺铂为基础的化疗（NAC；70mg/m）是肌层浸润性膀胱癌（MIBC）的标准治疗方法。许多患者（pts）由于肾功能损害而不能接受顺铂治疗，而在第 1 天和第 8 天或第 1 天和第 2 天（即分阶段方案）给予 35mg/m 的顺铂是一种常用的替代方案。在这项回顾性分析中，我们比较了分阶段方案（SS）和常规方案（CS）pts 在接受顺铂治疗后，在化疗方案、周期数、肿瘤组织学和临床分期相同的情况下，完全（pT0）和部分（<pT2）病理缓解率。我们匹配了 80 名患者。在 SS 和 CS 顺铂组中，pT0 率分别为 17.5%（95%置信区间[CI]，7%-33%）和 32.5%（95%CI，19%-49%）（ = .21），与 SS 顺铂相比，pT0 的优势比为 0.45（95%CI，0.16-1.31）。与全剂量相比，分阶段顺铂方案与数值上但无统计学意义的较低病理缓解率相关。
