|
|||||
|
|
Combination chemotherapy for advanced bilharzial bladder carcinoma |
|
| Authors: | Khaled, H. M. El-Mawla, N. Gad El-Said, A. Hamza, M.-R. Gaafar, R. El-Attar, I. Rabia, A. Abu Magrath, I. |
| Affiliation: | 1Departments of Medical Oncology, National Cancer Institute Cairo, Egypt 2Departments of Surgery, National Cancer Institute Cairo, Egypt 3Departments of Biostatistics, National Cancer Institute Cairo, Egypt 4Departments of Radiodiagnosis, National Cancer Institute Cairo, Egypt 5Lymphoma Biology Section, Pediatric Brunch, National Cancer Institute Bethesda, MD, USA |
| Abstract: | BACKGROUND:: Carcinoma of the bilharzial bladder, the most common cancerin Egyptian patients has been, until recently, largely treatedby surgery. We have studied the activity of a series of singleagents in phase II trials and identified a number of activeagents. Here we report the results of a trial in which therapeuticcombinations of the most active agents were administered inalternating cycles to patients who had never received chemotherapy. PATIENTS AND METHODS:: The study included 30 patients with histologically proven inoperable(20), recurrent (5, 2 of whom subsequently developed metastases),or metastatic disease (5). There were 27 males and 3 females,with a median age of 48.5 years (range 2965 years). Fourteenpatients had squamous cell carcinoma, 12 had transitional cellcarcinoma, 2 had adenocarcinoma, and the remaining 2 had undifferentiatedcarcinoma. Chemotherapy consisted of epidoxorubicin (120 mg/sqm i.v. d1)and vincristine (1.4 mg/sqm i.v., days 1 and 8) alternatingwith etoposide (100 mg/sqm i.v. infusion over 1 hour, days 1to 5) and ifosfamide (1800 mg/sqm i.v. infusion over 2 hours,days 1 to 5). Mesna was given as a uroprotector at 40% of theifosfamide dose at 0, 4, and 8 hours after the ifosfamide infusion.Courses were repeated every 34 weeks. RESULTS:: Among the 22 evaluable patients, 8 (36.5%) had a partial andone (4.5%), a complete response, giving a response rate of 46%.Three more patients had responses that were less than a partialremission, and 6 patients showed disease stabilisation on chemotherapy.Toxicities were tolerable and consisted mainly of myelosuppression. Results were further analysed in relation to pathologic subtype,disease status at the start of chemotherapy, and the delivereddose intensity. No relationship was found between any of theseparameters and response to therapy. CONCLUSION:: Advanced bilharzial bladder cancer is relatively sensitive tocombination chemotherapy, but complete remission and prolongedsurvival is rare in this subgroup of patients with advanceddisease. Further studies will be needed to determine the relativeefficacy of single agents and drug combinations. bilharziasis, bladder cancer, chemotherapy |
| Keywords: | |
| 本文献已被 Oxford 等数据库收录！ | |