論文

査読有り
2015年9月

Impact of renal function of patients with advanced urothelial cancer on eligibility for first-line chemotherapy and treatment outcomes

JAPANESE JOURNAL OF CLINICAL ONCOLOGY
  • Daishi Ichioka
  • ,
  • Jun Miyazaki
  • ,
  • Takamitsu Inoue
  • ,
  • Susumu Kageyama
  • ,
  • Mikio Sugimoto
  • ,
  • Koji Mitsuzuka
  • ,
  • Yoshiyuki Matsui
  • ,
  • Yusuke Shiraishi
  • ,
  • Hidefumi Kinoshita
  • ,
  • Hironobu Wakeda
  • ,
  • Takeshi Nomoto
  • ,
  • Eiji Kikuchi
  • ,
  • Hiroyuki Nishiyama

45
9
開始ページ
867
終了ページ
873
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/jjco/hyv082
出版者・発行元
OXFORD UNIV PRESS

The aim of the study is to clarify the clinical effects of first-line chemotherapy regimens for advanced urothelial cancer on clinical responses and survival of patients grouped by renal function.
In this multicenter retrospective cohort study, 345 urothelial cancer patients received systemic chemotherapy for metastatic or unresectable disease in 17 centers (2004-10).
Two hundred and forty-one patients were treated with methotrexate, vinblastine, doxorubicin and cisplatin/methotrexate, epirubicin and cisplatin (n = 136) or gemcitabine and cisplatin (n = 105) followed by carboplatin-based treatments, non-platinum treatments or other regimens. After 2008, gemcitabine and cisplatin was the most frequently used regimen in patients with an estimated glomerular filtration rate < 60 ml/min/1.73 m(2) and in those with estimated glomerular filtration rate a parts per thousand yen60 ml/min/1.73 m(2). The gemcitabine and cisplatin patients' complete response rate was 10.5% and their response rate was 52.4%, which was highest among all regimens. Gemcitabine and cisplatin demonstrated a better 3-year overall survival when the estimated glomerular filtration rate was a parts per thousand yen60 ml/min/1.73 m(2) (31.4%), but it tended to be worse when the estimated glomerular filtration rate was < 60 ml/min/1.73 m(2) (14.1%). In the latter cases, the dose reduction rate of gemcitabine and cisplatin was high (43.9%). Among the patients with estimated glomerular filtration rate < 60 ml/min/1.73 m(2), the 1-year overall survival of the patients treated with a reduced dose of gemcitabine and cisplatin was significantly lower than that of those treated with standard-dose gemcitabine and cisplatin (26.2 vs. 60.3%, respectively, P = 0.0108).
Gemcitabine and cisplatin provided favorable responses and survival in patients with estimated glomerular filtration rate a parts per thousand yen60 ml/min/1.73 m(2) but unsatisfactory oncological outcomes in patients with estimated glomerular filtration rate < 60 ml/min/1.73 m(2), especially when treated with a reduced dose. Alternative regimens might be optimal rather than reduced-dose gemcitabine and cisplatin in patients with estimated glomerular filtration rate < 60 ml/min/1.73 m(2).

Web of Science ® 被引用回数 : 9

リンク情報
DOI
https://doi.org/10.1093/jjco/hyv082
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26056328
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000361286500010&DestApp=WOS_CPL

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