GC化疗方案在不同转移性尿路上皮癌中的临床疗效观察

The outcome of Gemcitabine and Cisplatin combination chemotherapy in the treatment of metastatic urothelial cell carcinoma

目的总结吉西他滨+顺铂(Gemcitabine+Cisplatin,GC)化疗方案在尿路上皮癌(urothelialcellcarcinoma,UCC)中的临床治疗效果,以期提高晚期UCC患者的生存质量。方法回顾分析52例转移性UCC患者接受GC方案化疗后的临床资料。化疗效果参照实体瘤的疗效评价标准进行评价,化疗毒副作用按照WHO化疗毒副作用分级标准进行评价。结果 GC方案对转移性UCC患者总有效率为48.1%,其中单纯淋巴结转移患者的化疗有效率为64.3%,脏器转移者仅为29.2%。化疗中44.2%的患者出现Ⅱ度以上的骨髓抑制。随访时间平均17.6个月。统计分析表明单纯淋巴结转移较脏器转移患者化疗效果更好,生存期更长。结论 GC方案对晚期UCC的化疗效果肯定,化疗毒副作用小,但是要准确评估患者的体能状态和肾功能,谨慎选择合适的化疗对象。

Objective Gemcitabine＋Cisplatin （GC） has replaced the classical MVAC regimen as first line chemotherapy for metastatic urothelial cell carcinoma （UCC）. We summarize the data in our institute to evaluate the outcome of GC regimen in advanced UCC. Methods Retrospective analyses of patients with advanced UCC were performed. There were 52 cases, including 9 cases of upper urinary tract UCC and 43 cases of bladder cancer. We evaluate the effect of the chemotherapy according to the response evaluation criteria in solid tumors （RECIST）. Results The response rate is 64.30//00 in lymph nodes metastasis and 29.2~/oo in visceral metastases. About 44.20/00 of patients re- vealed thrombocytopenia and leucopenia in our study. Kaplan-meier analysis showed that visceral metastasis disease has worse long-term survival than lymph node-only disease. Conclusions GC regimen is a good choice for advanced UCC, however, patients with renal function impairment and decreased performance status are not eligible for cisplatin based chemotherapy.