Norihito Soga1, Takehisa Onishi, Kiminobu Arima, Yoshiki Sugimura. 1. Division of Nephro-Urologic Surgery and Andrology, Department of Reparative and Regenerative Medicine, Institute of Medical Life Science, Mie University Graduate School of Medicine, Mie, Japan. n-soga@clin.medic.mie-u.ac.jp
Abstract
OBJECTIVE: We evaluated the efficacy and toxicity of Paclitaxel Carboplatin (Pca) therapy in patients with advanced urothelial cancer and platinum based chemotherapy failure. PATIENTS AND METHODS: From April 2001 to September 2005, 18 patients were enrolled in this trial. The patients received methotrexate, vinblastine and doxorubicin cisplatin (M-VAC) therapy prior to Pca therapy. On day 1, Paclitaxel (175 mg/m(2), body surface) was injected followed by Carboplatin area under the curve (AUC) (5) via an external venous line and treatment was repeated on a 21-day cycle. Cases exhibiting either a response or stable disease were treated until progression of the disease was observed. All patients were examined to determine toxicity (National Cancer Institute common toxicity criteria) and QOL (EORTC QOL-C30). The survival curves were established using Kaplan-Meier graphs. RESULTS: The median cycle of Pca therapy was 4 cycles (range, 1-9 cycles). The overall survival response was 33% with a partial response in six patients (0 with CR, 6 with PR), stable disease in eight patients (44%) and disease progression in four patients (22%). Grade 3-4 anemia was recognized in 5 (28%), neutropenia in 9 (50%) and thrombocytopenia in 3 (22%). The QOL questionnaire scales showed no significant changes induced by Pca therapy. The progression free survival rates were 33% at 6 months, 16% at 1 year and 5.2% at 2 years. Regarding overall survival period, the 6 month, 1-year and 2-year estimates were 78%, 50% and 22%, respectively. CONCLUSION: Since the Pca therapy was well tolerated we consider that this treatment modality has the potential to prolong survival with a high quality of life when used as a second chemotherapy.
OBJECTIVE: We evaluated the efficacy and toxicity of Paclitaxel Carboplatin (Pca) therapy in patients with advanced urothelial cancer and platinum based chemotherapy failure. PATIENTS AND METHODS: From April 2001 to September 2005, 18 patients were enrolled in this trial. The patients received methotrexate, vinblastine and doxorubicin cisplatin (M-VAC) therapy prior to Pca therapy. On day 1, Paclitaxel (175 mg/m(2), body surface) was injected followed by Carboplatin area under the curve (AUC) (5) via an external venous line and treatment was repeated on a 21-day cycle. Cases exhibiting either a response or stable disease were treated until progression of the disease was observed. All patients were examined to determine toxicity (National Cancer Institute common toxicity criteria) and QOL (EORTC QOL-C30). The survival curves were established using Kaplan-Meier graphs. RESULTS: The median cycle of Pca therapy was 4 cycles (range, 1-9 cycles). The overall survival response was 33% with a partial response in six patients (0 with CR, 6 with PR), stable disease in eight patients (44%) and disease progression in four patients (22%). Grade 3-4 anemia was recognized in 5 (28%), neutropenia in 9 (50%) and thrombocytopenia in 3 (22%). The QOL questionnaire scales showed no significant changes induced by Pca therapy. The progression free survival rates were 33% at 6 months, 16% at 1 year and 5.2% at 2 years. Regarding overall survival period, the 6 month, 1-year and 2-year estimates were 78%, 50% and 22%, respectively. CONCLUSION: Since the Pca therapy was well tolerated we consider that this treatment modality has the potential to prolong survival with a high quality of life when used as a second chemotherapy.