Veronesi A, Lo Re G, Carbone A, Trovò M G, Dal Bo V, Talamini R, Santarossa S, Francini M, Monfardini S
Service of Oncology, General Hospital, Gorizia, Italy.
Eur J Cancer. 1994;30A(7):918-20. doi: 10.1016/0959-8049(94)90114-7.
22 patients with locally advanced (T3-T4, M0) transitional cell bladder carcinoma, age greater than 70 years, with medical contraindication or refusal of radical cystectomy, were treated following an ample transurethral resection (TUR), with three chemotherapy cycles. Each cycle consisted of 5-fluorouracil 500 mg/m2 intravenously (i.v.) on days 1 and 8, epirubicin 60 mg/m2 i.v. on day 1 and cisplatin 50 mg/m2 i.v. on day 1. Cycles were repeated every 3 weeks. Subsequently, patients were submitted to a repeat TUR on the area of the initial neoplasm. At computed tomography (CT) scan evaluation, response rate to chemotherapy was 54.5%, with two complete responses. No residual disease (R0) at postchemotherapy TUR was encountered in 8 cases (36%), and microscopic disease (R1) in 4 cases (18%). Median duration of complete responses (R0) was 13.5 months (range 7-57+). Radiation therapy was carried out in 12/14 patients with residual disease at repeat TUR. Overall median duration of response was 10.2 months, while overall actuarial median survival was 11.6 months. Four-year survival was 29%. The approach described was feasible. The chemotherapy regimen employed was not as active as current regimens used in younger patients. The search for more active regimens which are tolerable by the elderly is important.
22例局部晚期（T3 - T4，M0）移行细胞膀胱癌患者，年龄大于70岁，有医学禁忌证或拒绝行根治性膀胱切除术，在充分经尿道切除术（TUR）后接受三个周期的化疗。每个周期包括第1天和第8天静脉注射（i.v.）5 - 氟尿嘧啶500 mg/m²，第1天静脉注射表柔比星60 mg/m²，第1天静脉注射顺铂50 mg/m²。每3周重复一次周期。随后，患者在初始肿瘤部位接受再次经尿道切除术。在计算机断层扫描（CT）评估中，化疗的缓解率为54.5%，有两例完全缓解。化疗后经尿道切除术后无残留疾病（R0）的有8例（36%），有微小疾病（R1）的有4例（18%）。完全缓解（R0）的中位持续时间为13.5个月（范围7 - 57 +）。12/14例再次经尿道切除术后有残留疾病的患者接受了放射治疗。总体中位缓解持续时间为10.2个月，而总体精算中位生存期为11.6个月。四年生存率为29%。所描述的方法是可行的。所采用的化疗方案不如目前用于年轻患者的方案有效。寻找对老年人可耐受的更有效的方案很重要。
