Artigo Revisado por pares

ADJUVANT CHEMOTHERAPY WITH PACLITAXEL AND CARBOPLATIN IN PATIENTS WITH ADVANCED BLADDER CANCER: A STUDY BY THE HELLENIC COOPERATIVE ONCOLOGY GROUP

2004; Lippincott Williams & Wilkins; Volume: 171; Issue: 4 Linguagem: Inglês

10.1097/01.ju.0000118956.96871.18

ISSN

1527-3792

Autores

Aristotle Bamias, Ch. Deliveliotis, Gerasimos Aravantinos, Ch. Kalofonos, A. Karayiannis, Meletios Α. Dimopoulos,

Tópico(s)

Esophageal Cancer Research and Treatment

Resumo

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Apr 2004ADJUVANT CHEMOTHERAPY WITH PACLITAXEL AND CARBOPLATIN IN PATIENTS WITH ADVANCED BLADDER CANCER: A STUDY BY THE HELLENIC COOPERATIVE ONCOLOGY GROUP A. BAMIAS, Ch. DELIVELIOTIS, G. ARAVANTINOS, Ch. KALOFONOS, A. KARAYIANNIS, and M.A. DIMOPOULOS A. BAMIASA. BAMIAS , Ch. DELIVELIOTISCh. DELIVELIOTIS , G. ARAVANTINOSG. ARAVANTINOS , Ch. KALOFONOSCh. KALOFONOS , A. KARAYIANNISA. KARAYIANNIS , and M.A. DIMOPOULOSM.A. DIMOPOULOS View All Author Informationhttps://doi.org/10.1097/01.ju.0000118956.96871.18AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Radical cystectomy represents the treatment of choice for muscle infiltrative bladder carcinoma. Adjuvant chemotherapy has been used to improve outcome after cystectomy. We report results in a prospective cohort of patients at high risk for relapse who were treated with the combination of paclitaxel and carboplatin as adjuvant treatment following cystectomy for muscle invasive bladder cancer. Materials and Methods: A total of 92 patients with extravesical tumor extension (pT 3b or greater) or lymph node involvement (N+) were treated with 4 cycles of paclitaxel at 175 mg/m2 and carboplatin (area under the curve 5 according to the Calvert formula) every 3 weeks following radical cystectomy. Patients were followed every 6 months thereafter. Results: Median followup was 36.6 months. Chemotherapy was well tolerated with 62% of patients receiving 100% of the expected chemotherapy doses without delays. Grade 3 or 4 neutropenia was reported in 19% of patients, while neutropenic fever was reported in 7%. Five-year overall, cause specific and disease-free survival was 28.9% (95% CI 14.8 to 43.0), 36.6% (95% CI 24.4 to 49.7) and 29% (95% CI 16.3 to 42.4), respectively. Conclusions: Adjuvant chemotherapy with paclitaxel and carboplatin is feasible and could be used as adjuvant treatment for high risk bladder carcinoma. Its true value should be assessed in prospective, randomized trials. References 1 : Uncertainty and outcome in invasive bladder cancer. Urol Oncol1996; 2: 92. Google Scholar 2 : The role of systemic chemotherapy in the management of muscle-invasive bladder cancer. Lancet Oncol2002; 3: 738. Google Scholar 3 : The role of adjuvant chemotherapy following cystectomy for invasive bladder cancer: a prospective comparative trial. J Urol1991; 145: 459. Link, Google Scholar 4 : Advanced bladder cancer (stages pT3b, pT4a, pN1 and pN2): improved survival after radical cystectomy and 3 adjuvant cycles of chemotherapy. Results of a controlled prospective study. J Urol1992; 148: 302. Link, Google Scholar 5 : Adjuvant cisplatin chemotherapy following cystectomy for bladder cancer: results of a prospective randomized trial. J Urol1994; 152: 81. Link, Google Scholar 6 : A randomized trial of radical cystectomy versus radical cystectomy plus cisplatin, vinblastine and methotrexate chemotherapy for muscle invasive bladder cancer. J Urol1996; 155: 495. Link, Google Scholar 7 : Adjuvant chemotherapy in locally advanced bladder cancer: final analysis of a controlled multicentre study. Acta Urol Ital1997; 11: 5. Google Scholar 8 : Role of adjuvant chemotherapy in the treatment of invasive carcinoma of the urinary bladder. J Clin Oncol1998; 16: 1601. Google Scholar 9 : Significant activity of paclitaxel in advanced transitional-cell carcinoma of the urothelium: a phase II trial of the Eastern Cooperative Oncology Group. J Clin Oncol1994; 12: 2264. Google Scholar 10 : Phase II trial of docetaxel in patients with advanced or metastatic transitional-cell carcinoma. J Clin Oncol1997; 15: 1853. Google Scholar 11 : Carboplatin and urothelial tumors. Oncology1993; 50: 28. Google Scholar 12 : Paclitaxel plus carboplatin in advanced carcinoma of the urothelium: an active and tolerable outpatients regimen. J Clin Oncol1998; 16: 255. Google Scholar 13 : Phase II trial of paclitaxel and carboplatin in the treatment of advanced urothelial carcinoma. J Clin Oncol1998; 16: 1844. Google Scholar 14 : Non-parametric estimation for incomplete observations. J Am Stat Assoc1958; 53: 457. Google Scholar 15 : Controversies in neoadjuvant and adjuvant chemotherapy for muscle-invasive urothelial cancer and clinical research initiatives in locally advanced disease. In: ASCO Educational Book. Alexandria, Virginia: American Society of Clinical Oncology2003: 478. Google Scholar 16 : Chemotherapy in the post-MVAC era: the case for adjuvant chemotherapy. World J Urol2002; 20: 144. Google Scholar 17 : Adjuvant cyclophosphamide, doxorubicin, and cisplatin chemotherapy for bladder cancer: an update. J Clin Oncol1998; 6: 1590. Google Scholar 18 : The role of adjuvant combination chemotherapy after cystectomy in locally advanced bladder cancer: what we do not know and why. Ann Oncol2000; 11: 851. Google Scholar 19 : Adjuvant methotrexate, vinblastine and cisplatin chemotherapy for invasive transitional cell carcinoma: Taiwan experience. J Urol1996; 155: 118. Link, Google Scholar 20 : The role of radiation therapy in the management of transitional cell carcinoma of the bladder. Hematol Oncol Clin North Am1992; 6: 147. Google Scholar From the Departments of Clinical Therapeutics and Urology, University of Athens, School of Medicine (AB, CD, AK, MAD) and Medical Oncology Department, Agii Anargyri (GA), Athens and Department of Internal Medicine, University of Patra, School of Medicine (CK), Rio, Greece© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 171Issue 4April 2004Page: 1467-1470 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsbladder neoplasmscarboplatinchemotherapy, adjuvantpaclitaxelbladderMetricsAuthor Information A. BAMIAS More articles by this author Ch. DELIVELIOTIS More articles by this author G. ARAVANTINOS More articles by this author Ch. KALOFONOS More articles by this author A. KARAYIANNIS More articles by this author M.A. DIMOPOULOS More articles by this author Expand All Advertisement PDF downloadLoading ...

Referência(s)
Altmetric
PlumX