Dimopoulos M A, Finn L, Logothetis C J
Department of Genitourinary Oncology, University of Texas M. D. Anderson Cancer Center, Houston.
J Urol. 1994 Mar;151(3):598-600; discussion 600-1. doi: 10.1016/s0022-5347(17)35025-5.
Cis-platinum-based chemotherapy combinations have improved the outcome of patients with metastatic urothelial tumors, since two-thirds of these patients respond to treatment. Nevertheless, the majority of such patients have relapse within a median of 12 months. To define the pattern of failure and subsequent outcome, we retrospectively assessed 58 consecutive patients with relapse after prior response to cis-platinum-based combination chemotherapy. Of the patients who presented initially with local-regional metastases, 74% had relapse with involvement of a similar site, while only 26% of these patients had visceral metastases at relapse. The median survival after relapse was 9 months, and parameters associated with longer survival were local-regional relapse (10.7 months) and response to salvage chemotherapy (12.6 months). These data suggest that select patients with urothelial tumors and local-regional metastases may benefit from consolidation therapy with surgery or radiotherapy after maximum response to chemotherapy.
基于顺铂的化疗联合方案改善了转移性尿路上皮肿瘤患者的治疗结果，因为这些患者中有三分之二对治疗有反应。然而，大多数此类患者在中位12个月内复发。为了确定失败模式及后续结果，我们回顾性评估了58例先前对基于顺铂的联合化疗有反应后复发的连续患者。最初表现为局部区域转移的患者中，74%复发时累及相似部位，而这些患者中只有26%在复发时有内脏转移。复发后的中位生存期为9个月，与较长生存期相关的参数是局部区域复发（10.7个月）和对挽救性化疗的反应（12.6个月）。这些数据表明，部分患有尿路上皮肿瘤和局部区域转移的患者在对化疗达到最大反应后，可能从手术或放疗的巩固治疗中获益。
