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Phase II trial of neoadjuvant gemcitabine and cisplatin in patients with resectable bladder carcinoma
Herchenhorn, Daniel; Dienstmann, Rodrigo; Peixoto, Fabio A; Campos, Franz S. de; Santos, Valdelice O; Moreira, Denise M; Cardoso, Hedilene; Small, Isabele A; Ferreira, Carlos G.
Afiliação
  • Herchenhorn, Daniel; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Departments of Clinical Oncology. Rio de Janeiro. BR
  • Dienstmann, Rodrigo; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Rio de Janeiro. BR
  • Peixoto, Fabio A; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Departments of Clinical Oncology. Rio de Janeiro. BR
  • Campos, Franz S. de; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Departments of Clinical Oncology. Rio de Janeiro. BR
  • Santos, Valdelice O; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Rio de Janeiro. BR
  • Moreira, Denise M; National Cancer Institute. Clinical Cancer Research. Radiology. Rio de Janeiro. BR
  • Cardoso, Hedilene; Eli Lilly Medical Support. Rio de Janeiro. BR
  • Small, Isabele A; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Rio de Janeiro. BR
  • Ferreira, Carlos G; National Cancer Institute. Clinical Cancer Research, Urology and Radiology. Rio de Janeiro. BR
Int. braz. j. urol ; 33(5): 630-638, Sept.-Oct. 2007. graf, tab
Article em En | LILACS | ID: lil-470213
Biblioteca responsável: BR1.1
ABSTRACT

OBJECTIVES:

Gemcitabine and cisplatin (GC) is an active combination in the treatment of metastatic bladder cancer. We have prospectively analyzed the efficacy and tolerability of GC as neoadjuvant treatment of invasive bladder cancer MATERIALS AND

METHODS:

In this single-institution phase II trial, patients with muscle-invasive transitional cell carcinoma received three cycles of gemcitabine 1200 mg/m² on days 1 and 8 with cisplatin 75 mg/m² on day 1 prior to surgery. Radiologic response was evaluated by computed tomography and magnetic resonance imaging. All patients were referred to surgery after chemotherapy completion

RESULTS:

Between June 2002 and March 2005, 22 patients (19 males) were enrolled. Median age was 63 years. Initial stage was II (T2) in 11 and III (T3-4) in 11 patients. Median follow-up is 26 months (4-43). Partial or complete radiologic response rate was documented in 13 out of 20 assessable patients (70 percent). One patient was excluded due to sarcomatoid carcinoma at definitive pathologic examination. Cystectomy was performed in 15 patients and pelvic radiotherapy in four patients. Nine out of 21 patients (43 percent) relapsed and four (19 percent) died due to disease progression. Complete pathologic response was observed in four patients (26.7 percent of 15). Median progression-free survival was 27 months (CI 95 percent not reached) with median overall survival of 36 months (CI 95 percent 28.7 - 43.3). Grade III/IV toxicity was infrequent, with no deaths due to chemotherapy

CONCLUSIONS:

The combination of GC is effective and well-tolerated when used as neoadjuvant therapy in muscle-invasive bladder cancer. Longer follow-up is necessary to evaluate its impact on the overall survival of these patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Neoplasias da Bexiga Urinária / Carcinoma de Células de Transição / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male Idioma: En Revista: Int. braz. j. urol Assunto da revista: UROLOGIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Neoplasias da Bexiga Urinária / Carcinoma de Células de Transição / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male Idioma: En Revista: Int. braz. j. urol Assunto da revista: UROLOGIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil