吉西他滨联合奥沙利铂治疗浸润性和转移性尿路上皮癌的临床研究

目的：评价吉西他滨联合奥沙利铂治疗浸润性和转移性尿路上皮癌的疗效以及毒副作用。方法：入选病例20例经病理证实尿路上皮癌， 其中膀胱癌14例，输尿管癌3例，肾盂癌3例， 均为浸润性或转移性尿路上皮癌，化疗前Karnofsky评分≥60分，化疗方案： 吉西他滨1 250mg/m2，静脉滴注d1，8，奥沙利铂50mg/m2静脉滴注d2，3，4周为1个周期， 连续治疗2个周期以上进行评估。该方案分别运用于姑息性化疗、新辅助化疗、 辅助化疗。结果： 按WHO疗效评定标准，完全缓解 （CR） 5例 （25%）， 部分缓解（PR） 6例 （30%）， 稳定 （SD） 5例 （25%），进展 （PD）4例 （20%）， 近期有效率55%。主要不良反应为血小板下降， 白细胞下降， 恶心呕吐和便秘， 大多为轻中度， 且化疗停止后很快缓解， 未发生治疗相关死亡。结论： 吉西他滨联合奥沙利铂治疗局部晚期和转移性尿路上皮癌的疗效满意， 毒副作用较轻。

Effect of Combined Treatment with Gemcitabine and Oxaliplatin on Advanced or Metastatic Urothelial Carcinoma

Effect of Combined Treatment with Gemcitabine and Oxaliplatin on Advanced orMetastaticUrothelial CarcinomaXuyang YAN1, Dong LI1, Guang DU1, Ping YUAN1, Zhen FANG1, Dengke YANG1Corresponding author: Guang DU, E-mial: duguang2003@yahoo.com.cn1Department of Urology, St LUKE's Hospital, Shanghai 200050, China2Department of Urology, Reijin Hospital of Shanghai Jiaotong Medical University, Shanghai 200050, ChinaAbstract Objective: To evaluate the therapeutic effect and toxicities of Gemcitabine combined with Oxaliplatin on advanced ormetastatic urothelial carcinoma. Methods: A total of 20 patients pathologically confirmed with advanced or metastatic urothelial carci-noma ( 14 cases of bladder cancer, 3 cases of renal pelvic carcinoma, and 3 cases of ureteral carcinoma ) were reviewed. Karnofskyscore for each patient before therapy was ≥ 60. Combined treatment with Gemcitabine and Oxaliplatin regimen was as follows: Gem-citabine 1250 mg/m2, iv infusion at day 1 and day 8, Oxaliplatin 50 mg/m2, iv infusion at day 2 and day 3. The regimen was adminis-tered for more than 2 cycles ( every 4 weeks ) and the response rate was evaluated. The regimen was used in palliative chemotherapy,neoadjuvant chemotherapy and adjuvant chemotherapy, respectively. Results: According to WHO evaluation criteria on therapeutic ef-fectiveness, 5 patients ( 25 % ) had complete response, 6 patients ( 30 % ) had partial response, 5 cases ( 25 % ) remained stable status,and 4 cases ( 20 % ) had progression. The overall response rate was 55 %. The main side effects included thrombocytopenia, leucope-nia, nausea, vomiting and constipation, which were mild or moderate and disappeared when the chemotherapy was ceased. No chemo-therapy related death occurred. Conclusion: Combined treatment with Gemcitabine and Oxaliplatin is effective for advanced or meta-static urothelial carcinoma, with mild and tolerable toxicities.Keywords Urothelial carcinoma; Gemcitabine; Oxaliplatin; Combined chemotherapy