Kish J A, Wolf M K, Schellhammer P F, Hussain M H, Einstein A B, Crawford E D
Henry Ford Hospital, Division of Hematology/Oncology, Detroit, MI 48202-2689, USA.
Am J Clin Oncol. 1997 Aug;20(4):327-30. doi: 10.1097/00000421-199708000-00001.
Significant toxicities result from the use of MVAC (methotrexate, vinblastine, adriamycin, cisplatin) for advanced/ recurrent transitional cell carcinoma of the bladder (ARTCCB). An alternative regimen of 5-fluorouracil (5-FU) and cisplatin was evaluated by Southwest Oncology Group (SWOG). Thirty-eight patients with ARTCCB were treated with continuous infusion 5-FU 1,000 mg/m2/days 1-5 and cisplatin 100 mg/day 1, on a every-21-days schedule. There were two complete responses (CR) and eight partial responses (PR) among 36 eligible patients, for an overall response rate of 28% [95% confidence interval (CI) 14-45%]. Median duration of response was 6 months, and median duration of survival was 9 months. No toxic deaths occurred. Grade 4 leukopenia occurred in 5 patients. Other toxicities were mild. Only two documented infections occurred in 5 patients with neutropenia. The response rate of 28% is better than that achieved with cisplatin alone and not dissimilar to the range of response for MVAC. Toxicities were less and tolerable. This regimen will need further evaluation.
使用甲氨蝶呤、长春花碱、阿霉素、顺铂（MVAC）治疗晚期/复发性膀胱移行细胞癌（ARTCCB）会产生显著毒性。西南肿瘤协作组（SWOG）对5-氟尿嘧啶（5-FU）和顺铂的替代方案进行了评估。38例ARTCCB患者接受了持续输注5-FU 1000mg/m²，第1 - 5天，和顺铂100mg/第1天的治疗，每21天为一个疗程。36例符合条件的患者中有2例完全缓解（CR）和8例部分缓解（PR），总缓解率为28%[95%置信区间（CI）14 - 45%]。中位缓解持续时间为6个月，中位生存时间为9个月。未发生毒性死亡。5例患者出现4级白细胞减少。其他毒性较轻。5例中性粒细胞减少患者中仅记录到2例感染。28%的缓解率优于单独使用顺铂的情况，与MVAC的缓解范围相似。毒性较小且可耐受。该方案需要进一步评估。
