Ondrus D, Hornák M, Bárdos A, Ondrus B
Department of Urology, Comenius University School of Medicine, Dérer Hospital, Bratislava, Slovakia.
Neoplasma. 1994;41(5):263-8.
A total of 60 patients with muscle invasive transitional cell carcinoma of the bladder were entered into the nonrandomized study. The 1st group consisted of 30 patients treated by M-VAC neo-adjuvant chemotherapy followed by radical cystectomy when a residual tumor had been detected by biopsy made after the treatment. The overall clinical response was 70%. Fifteen (50%) out of 30 patients achieved clinical complete response (cCR). Objective pathologic response was attained in 6 (66.7%) of 9 evaluable patients who underwent radical cystectomy, pathologic complete response (pCR) was observed in two (22.2%) patients. Ten (33.3%) patients are still alive at a median follow-up of 22+ months. There were three (10%) drug-related deaths. The 2nd group consisted of 30 patients treated by CMV (with carboplatin) neo-adjuvant chemotherapy followed by radical pathologic response was attained in 9 (47.4%) of 19 evaluable patients, with pCR in 6 (31.6%) patients. Twenty four (80%) patients are still alive at a median follow-up of 13+ months. There was one (3.3%) drug-related death. The authors recommend immediate radical cystectomy following neo-adjuvant chemotherapy in all patients if their total status it allows.
共有60例膀胱肌肉浸润性移行细胞癌患者进入这项非随机研究。第一组由30例患者组成，他们接受M-VAC新辅助化疗，若治疗后活检发现残留肿瘤，则随后进行根治性膀胱切除术。总体临床缓解率为70%。30例患者中有15例（50%）达到临床完全缓解（cCR）。在接受根治性膀胱切除术的9例可评估患者中，6例（66.7%）达到客观病理缓解，2例（22.2%）患者观察到病理完全缓解（pCR）。在中位随访22 +个月时，10例（33.3%）患者仍然存活。有3例（10%）与药物相关的死亡。第二组由30例患者组成，他们接受CMV（联合卡铂）新辅助化疗，随后进行根治性膀胱切除术。在19例可评估患者中，9例（47.4%）达到病理缓解，6例（31.6%）患者达到pCR。在中位随访13 +个月时，24例（80%）患者仍然存活。有1例（3.3%）与药物相关的死亡。作者建议，如果所有患者的总体状况允许，在新辅助化疗后立即进行根治性膀胱切除术。
