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Sequential chemotherapy using gemcitabine + carboplatin followed by gemcitabine + carboplatin + docetaxel for advanced upper-tract urothelial cancer.
- Source :
-
International journal of clinical oncology [Int J Clin Oncol] 2015 Dec; Vol. 20 (6), pp. 1179-84. Date of Electronic Publication: 2015 May 26. - Publication Year :
- 2015
-
Abstract
- Background: Retrospective evaluation of the effectiveness and adverse events (AEs) of a sequential chemotherapy regimen using gemcitabine + carboplatin (GCarbo) followed by GCarbo + docetaxel (GCarboD) for advanced upper-tract urothelial carcinoma (UTUC).<br />Methods: We treated 56 patients with advanced UTUC. Mean patient age was 68.9 years, creatinine clearance was 51.2 mL/min, and the observation period was 20 months. Patients received two courses of GCarbo comprising 800 mg/m(2) gemcitabine on days 1, 8, and 15, and carboplatin at an area under the curve of four on day 2. If this regimen was effective, we administered two more courses of GCarbo; if the regimen was ineffective, we switched to two courses of GCarboD (70 mg/m(2)).<br />Results: Complete (n = 3) and partial response (PR; n = 25) were achieved after GCarbo. Mean response duration was 9.7 months. Two of 17 cases achieved PR after GCarboD treatment (mean duration, 31.5 months). Median survival was 14.0 months with the GCarbo/GCarboD regimen. Responders to GCarbo therapy survived significantly longer. AEs with the GCarbo regimen included 31 instances of G3/4 blood toxicity and 8 instances of G3/4 urticaria; however, there were only 6 instances of G3/4 gastrointestinal complications. AEs with the GCarboD regimen included 16 instances of blood toxicity and 8 instances of gastrointestinal complications. Neither regimen resulted in G3/4 renal toxicity.<br />Conclusions: GCarbo and GCarboD chemotherapy may be administered safely to patients with advanced UTUC, with or without renal dysfunction. Response to GCarbo was high (50.0 %) whereas GCarboD was of limited effectiveness for non-responders to GCarbo.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols adverse effects
Carboplatin administration & dosage
Carcinoma, Transitional Cell metabolism
Carcinoma, Transitional Cell pathology
Creatinine metabolism
Deoxycytidine administration & dosage
Deoxycytidine analogs & derivatives
Docetaxel
Female
Humans
Male
Middle Aged
Retrospective Studies
Survival Rate
Taxoids administration & dosage
Treatment Outcome
Urologic Neoplasms metabolism
Urologic Neoplasms pathology
Gemcitabine
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Transitional Cell drug therapy
Urologic Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1437-7772
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 26007690
- Full Text :
- https://doi.org/10.1007/s10147-015-0846-z