Scher H I, Yagoda A, Herr H W, Sternberg C N, Morse M J, Sogani P C, Watson R C, Reuter V, Whitmore W F, Fair W R
Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
J Urol. 1988 Mar;139(3):475-7. doi: 10.1016/s0022-5347(17)42496-7.
A total of 11 patients with stage T2-4N0M0 extravesical tumors (prostate, prostatic urethra, urethra and ureter) received 1 to 4 cycles of neoadjuvant methotrexate, vinblastine, doxorubicin and cisplatin. Of 10 evaluable patients 4 (40 per cent) had downstaging to T0 disease with a clinical complete remission observed in 3 of 5 (60 per cent) with transitional cell tumors of the prostate and prostatic urethra. Four patients with urethral tumors of mixed or nontransitional histology failed to achieve a complete remission. The disease was staged pathologically in 4 patients: 1 had a partial remission and 3 had progression (all 4 had residual disease). Because therapy with methotrexate, vinblastine, doxorubicin and cisplatin induced only significant tumor regression of transitional cell elements of extravesical tumors and because it was ineffective against mixed histological tumors and in preventing new stage Tis lesions, surgical resection of such lesions is required.
共有11例T2 - 4N0M0期膀胱外肿瘤（前列腺、前列腺尿道、尿道和输尿管）患者接受了1至4周期的新辅助甲氨蝶呤、长春碱、阿霉素和顺铂治疗。在10例可评估的患者中，4例（40%）病情降期至T0期，5例前列腺和前列腺尿道移行细胞肿瘤患者中有3例（60%）实现了临床完全缓解。4例组织学为混合性或非移行性的尿道肿瘤患者未实现完全缓解。4例患者进行了病理分期：1例部分缓解，3例病情进展（4例均有残留病灶）。由于甲氨蝶呤、长春碱、阿霉素和顺铂治疗仅能使膀胱外肿瘤的移行细胞成分显著消退，且对混合组织学肿瘤无效，也无法预防新的Tis期病变，因此需要对这类病变进行手术切除。
