論文

査読有り
2016年12月

Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan: a Japanese multi-institutional study (CURE study)

International Journal of Clinical Oncology
  • Yoshiyuki Matsui
  • ,
  • Osamu Ogawa
  • ,
  • Ryutaro Ishitsuka
  • ,
  • Jun Miyazaki
  • ,
  • Takamitsu Inoue
  • ,
  • Susumu Kageyama
  • ,
  • Mikio Sugimoto
  • ,
  • Koji Mitsuzuka
  • ,
  • Yusuke Shiraishi
  • ,
  • Hidefumi Kinoshita
  • ,
  • Hironobu Wakeda
  • ,
  • Takeshi Nomoto
  • ,
  • Eiji Kikuchi
  • ,
  • Keiko Fujie
  • ,
  • Naoto Keino
  • ,
  • Hiroyuki Nishiyama

21
6
開始ページ
1142
終了ページ
1149
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10147-016-1007-8
出版者・発行元
SPRINGER JAPAN KK

The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ae<yen>80 years.
Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ae<yen>80 years was reviewed before and after 2008 and compared with 315 young patients.
There were only 7 (4.6 %) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 %) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 %) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis.
Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.


リンク情報
DOI
https://doi.org/10.1007/s10147-016-1007-8
J-GLOBAL
https://jglobal.jst.go.jp/detail?JGLOBAL_ID=201702237062569642
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/27349431
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000389202200016&DestApp=WOS_CPL