CAJ | 학술논문

目的探讨低剂量吉西他滨联合奥沙利铂治疗浸润性和转移性尿路上皮癌的疗效和安全性.方法回顾性分析2009年1月至2013年5月收治的42例经病理检查证实为肌层浸润性或转移性尿路上皮癌患者的资料,其中膀胱癌23例,输尿管癌11例,肾盂癌8例.化疗前Karnofsky评分均＞60分.化疗方案为:吉西他滨700 mg/m2,第1、8、15天静脉滴注;奥沙利铂100 mg/m2,第2天静脉滴注;28 d为1个周期.结果本组42例中,17例完成2个周期,19例完成4个周期,5例完成6个周期,1例因过敏反应仅完成1个周期.随访6～ 24个月,按WHO疗效评定标准:完全缓解7例(16.7％),部分缓解13例(30.9％),稳定14例(33.3％),进展8例(19.1％).随访6个月时有效率为47.6％ (20/42),疾病控制率为80.9％ (34/42).主要化疗不良反应:骨髓抑制,包括白细胞下降18例(42.9％),血小板下降16例(38.1％),贫血15例(35.7％);恶心、呕吐10例(45.2％);纳差、乏力20例(47.6％);脱发13例(30.9％).其中38例(90.5％)为轻、中度,Ⅲ度以上不良反应仅4例(9.5％),且化疗停止后很快缓解,未发生化疗相关死亡病例.结论低剂量吉西他滨联合奥沙利铂治疗晚期尿路上皮癌安全有效,不良反应轻.
목적 탐토저제량길서타빈연합오사리박치료침윤성화전이성뇨로상피암적료효화안전성.방법 회고성분석2009년1월지2013년5월수치적42례경병리검사증실위기층침윤성혹전이성뇨로상피암환자적자료,기중방광암23례,수뇨관암11례,신우암8례.화료전Karnofsky평분균＞60분.화료방안위:길서타빈700 mg/m2,제1、8、15천정맥적주;오사리박100 mg/m2,제2천정맥적주;28 d위1개주기.결과 본조42례중,17례완성2개주기,19례완성4개주기,5례완성6개주기,1례인과민반응부완성1개주기.수방6～ 24개월,안WHO료효평정표준:완전완해7례(16.7％),부분완해13례(30.9％),은정14례(33.3％),진전8례(19.1％).수방6개월시유효솔위47.6％ (20/42),질병공제솔위80.9％ (34/42).주요화료불량반응:골수억제,포괄백세포하강18례(42.9％),혈소판하강16례(38.1％),빈혈15례(35.7％);악심、구토10례(45.2％);납차、핍력20례(47.6％);탈발13례(30.9％).기중38례(90.5％)위경、중도,Ⅲ도이상불량반응부4례(9.5％),차화료정지후흔쾌완해,미발생화료상관사망병례.결론 저제량길서타빈연합오사리박치료만기뇨로상피암안전유효,불량반응경.
Objective To evaluate the therapeutic effect and toxicities of low dose Gemcitabine combined with Oxaliplatin in the treatment of advanced or metastatic uroedthelial carcinoma.Methods A total of 42 patients pathologically confirmed advanced or metastatic urothelial carcinoma (23 bladder cancer cases,11 ureteral carcinoma cases,and 8 renal pelvic carcinoma cases) were reviewed.Karnofsky score for each patient before treatment was more than 60.Combined treatment with Gemcitabine and Oxaliplatin regimen was as follows:Gemcitabine 700 mg/m2,iv infusion at day 1,8 and day 15,Oxaliplatin 100 mg/m2,iv infusion at day 2.The regimen was administered for more than 2 cycles (every 4 weeks) and the response rate was evaluated.The regimen was used in palliative chemotherapy and adjuvant chemotherapy,respectively.Results According to WHO evaluation criteria on therapeutic effectiveness,7 patients (16.7％) had complete response,13 patients (30.9％) had partial response,14 cases (33.3％) remained stable status,and 8 cases (19.1％) had progression.The overall response rate was 47.6％.The main side effects included thrombocytopenia,leucopenia,nausea,vomiting and alopecia,which were mild to moderate and disappeared when the chemotherapy was ceased.No chemotherapy related death occurred.Conclusions Combined treatment with low dose Gemcitabine and Oxaliplatin is effective for advanced or metastatic urothelial carcinoma,with mild and tolerable toxicities.