吉西他滨联合顺铂方案治疗晚期尿路上皮移行细胞癌18例报告

Combination of gemcitabine with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma of urinary tract (report of 18 cases)

目的评价吉西他滨联合顺铂方案治疗晚期尿路上皮移行细胞癌的疗效和毒副作用.方法病理证实的尿路上皮移行细胞癌患者18例,其中膀胱癌15例,肾盂癌2例,输尿管癌1例.化疗前Karnofsy评分≥60分,肝肾功能和血常规均正常,全身化疗方案:吉西他滨1000 mg/m2,静脉滴注30 min,第1、8天各1次,顺铂30 mg/m2,静脉滴注,第2、8、9天各1次.3～4周重复1次,连用2～3个周期后进行疗效评价.结果完全缓解3例(16.7%),部分缓解7例(38.9%),无变化5例(27.8%),进展3例(16.7%),总有效率55.6%.主要不良反应为白细胞下降(10例)、贫血(7例)、恶心呕吐(10例)和便秘(8例),均为轻中度.未发生治疗相关死亡.结论吉西他滨联合顺铂方案治疗晚期尿路上皮移行细胞癌的疗效肯定,毒副作用较轻,可作为一线治疗方案.

ObjectiveTo evaluate the therapeutic effect and toxicities of gemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma (TCC) of urinary tract. Methods Eighteen patients with advanced or metastatic TCC of urinary tract (15 cases of bladder TCC,2 of renal pelvic TCC,and 1 of ureteral TCC),who were pathologically confirmed,were treated with GC regimen (gemcitabine 1000 mg/m 2,iv infusion on day 1 and day 8;cisplatin 30 mg/m 2,iv infusion on day 2,day 8 and day 9).Before treatment, Karnofsy score for each patient was evaluated with a result of ≥60;liver and renal functions and blood routine test were normal.GC regimen was repeated for 2-3 cycles every 3-4 weeks and the response rate was evaluated.ResultsThree patients (16.7%) had complete response; 7(38.9%), partial response;5(27.8%),no response;and 3(16.7%) had progression.The overall response rate was 55.6%. The main toxic effects included decrease in white cell count (10 cases),anemia (7),nausea and vomiting (10) and constipation (8),which were mild or moderate and disappeared after stopping treatment.No chemotherapy-associated death occurred.ConclusionsGemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma of urinary tract is effective,and the toxicity is mild and tolerated. It is suggested that GC regimen can be used as the first line chemotherapy.