序贯化疗在泌尿道移行细胞癌中的应用探索

Exploring sequenced chemotherapy regimens in the treatment of transitional cell carcinoma of the urothelial tract

目的评价在晚期移行细胞癌病人应用阿霉素＋吉西他滨（AG）每2周一周期，共6周期，序贯异磷酰胺＋紫杉醇＋顺铂（ITP）每3周一周期，共4周期方案的耐受性及疗效。方法AG每2周为一周期，共6周期，序贯ITP每3周为一周期，共4周期。15例病人分别接受5种AG剂量水平的方案化疗，最高剂量是阿霉素50mg／m^2，吉西他滨2000mg／m^2；ITP方案的剂量为异磷酰胺1500mg／m^2第1～3天，紫杉醇135mg／m^2及顺铂70mg／m^2第1天。每个治疗周期间应用粒细胞集落刺激因子。结论AG方案隔周给药阿霉素50mg／m^2、吉西他滨2000mg/m^2是可行的。AG—ITP序贯化疗结束后9／14（64％）有效（3例CR；6例PR）。

To evaluate the two - drug regimen doxorubicin and gemcitabine （AG） every other week for six cycles followed by ifosfamide, paclitaxel and cisplatin （ ITP ） every 3 weeks for four cycles in patients with transitional cell carcinoma of the urothelial tract. 15 patients were treated at five AG dose levels ranging up to doxorubicin 50 mg/m^2 and gemcitabine 2000 mg/m^2. The dose and schedule of ITP were constant at ifosfamide 1500 mg/m^2 on days 1 -3 and paclitaxel 200 mg/ m2 and cisplatin 70 mg/m^2 on day 1. Granulocyte colony - stimulating factor was administered between all cycles of therapy. The trial determined that AG given at alternating weeks at doses of doxornbicin 50 mg/m^2 and gemcitabine 2000 mg/m^2 was feasible. After completion of the AG - ITP sequence, 9 of 14 （64% ） evaluable patients had a major response （3 complete responses and 6 partial responses ）.1