Shinohara Mayuka, Hata Shinro, Inoue Toru, Shibuya Tadamasa, Ando Tadasuke, Mimata Hiromitsu, Shin Toshitaka
Department of Urology, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan.
Department of Renal Surgery and Urology, Oita University Hospital, Yufu, Oita 879-5593, Japan.
Mol Clin Oncol. 2024 Apr 1;20(5):37. doi: 10.3892/mco.2024.2735. eCollection 2024 May.
Gemcitabine plus cisplatin (GC) is the standard first line of chemotherapy for urothelial carcinoma. However, it is often difficult to complete scheduled GC therapy because of real-world adverse events. Therefore, the reasons behind delays, scheduled cancelations and determined predictive factors for completing scheduled GC therapy were retrospectively analyzed. Patients diagnosed with locally advanced or metastatic urothelial carcinoma from 2009 to 2020 received a 4-week GC therapy schedule in Oita University Hospital. Information was retrospectively extracted from medical records and all cycles were divided into two groups: One wherein all treatments were administered and completed on schedule and the other wherein treatment was either delayed or canceled in during the treatment schedule. Predictive factors were then statistically extracted between the two groups. In total, 70 patients received 201 cycles of a 4-week scheduled GC therapy. Of the 201 cycles, a total of 68 (33.8%) completed all scheduled treatments, while 133 (66.1%) did not complete the treatment as scheduled. In the group where administration was not completed on schedule, the factors of male, ureteral cancer, lower stage, <90% of gemcitabine and cisplatin dosage, solitary kidney, high creatinine level, low estimated glomerular filtration rate level, low platelet count and high alkaline phosphatase level at the initiation of each cycle were more significant. Additionally, the lowest anticancer drug percentage administration was on day 15. From these results, predictive factors for patients with various backgrounds who completed the scheduled 4-week GC therapy based on real-world data were identified. This information can be useful for clinical physicians when deciding the course of treatment.
吉西他滨联合顺铂（GC）是尿路上皮癌的标准一线化疗方案。然而，由于现实世界中的不良事件，往往难以完成预定的GC治疗。因此，我们对治疗延迟、计划取消的原因以及完成预定GC治疗的决定性预测因素进行了回顾性分析。2009年至2020年期间，在大分大学医院被诊断为局部晚期或转移性尿路上皮癌的患者接受了为期4周的GC治疗方案。我们从医疗记录中回顾性提取信息，并将所有疗程分为两组：一组是所有治疗均按计划给药并完成，另一组是在治疗过程中治疗被延迟或取消。然后在两组之间进行统计学提取预测因素。共有70名患者接受了201个周期的为期4周的预定GC治疗。在这201个周期中，共有68个（33.8%）完成了所有预定治疗，而133个（66.1%）未按计划完成治疗。在未按计划完成给药的组中，男性、输尿管癌、较低分期、吉西他滨和顺铂剂量<90%、孤立肾、肌酐水平高、估计肾小球滤过率水平低、血小板计数低以及每个周期开始时碱性磷酸酶水平高这些因素更为显著。此外，第15天的抗癌药物给药百分比最低。从这些结果中，我们确定了基于现实世界数据完成预定4周GC治疗的不同背景患者的预测因素。这些信息在临床医生决定治疗方案时可能会有所帮助。
