https://scholars.lib.ntu.edu.tw/handle/123456789/487357
Title: | Weekly cisplatin plus infusional high-dose 5-fluorouracil and leucovorin (P-HDFL) for metastatic urothelial carcinoma: An effective regimen with low toxicity | Authors: | CHIA-CHI LIN CHIH-HUNG HSU CHAO-YUAN HUANG ANN-LII CHENG Chen J. Vogelzang N.J. YEONG-SHIAU PU |
Issue Date: | 2006 | Journal Volume: | 106 | Journal Issue: | 6 | Start page/Pages: | 1269-1275 | Source: | Cancer | Abstract: | BACKGROUND. Conventional systemic chemotherapy for metastatic urothelial carcinoma (UC) such as methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) or cisplatin, methotrexate, and vinblastine (CMV) is associated with significant dose-limiting toxicities and even treatment-related death. The authors developed a regimen that was designed to maintain efficacy, while reducing toxicities. METHODS. Between January 1998 and July 2003, 35 patients (median age, 71 yrs) with metastatic UC were treated with 4-week cycles of P-HDFL (cisplatin 35 mg/m2, high-dose 5-fluorouracil [5-FU] 2,600 mg/m2, and leucovorin 300 mg/m2, on Days 1 and 8, all given by 24-hr infusion). On Day 15, only HDFL was given again. RESULTS. Among the 32 patients treated with ? 2 cycles, 9 (28.1%) and 11 (34.4%) were complete and partial responders, respectively, with an overall response rate of 62.5% (95% confidence interval [CI], 45.9-79.2%). The median overall and progression-free survival was 12.3 months (95% CI, 8.2-16.4 mos) and 10.5 months (95% CI, 8.4-12.6 mos), respectively. Toxicity in a total of 121 courses (mean, 3.5 per patient) was modest, with WHO Grade 3 or 4 leukopenia and thrombocytopenia noted in only 1 and 0 patients, respectively. Grade 3 or 4 nausea, vomiting, mucositis, and diarrhea were noted in 3, 2, 0, and 2 patients, respectively. In general, patients tolerated the regimen very well. CONCLUSIONS. P-HDFL is a moderately active and considerably low-toxic regimen for metastatic UC. The excellent toxicity profile makes it a viable option for patients with poor general conditions. To reach any conclusion, randomized trials comparing P-HDFL with traditional cisplatin-based regimens are necessary. ? 2006 American Cancer Society. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-33644838678&doi=10.1002%2fcncr.21738&partnerID=40&md5=fea4d9945247411ace163153a7c8ae1f https://scholars.lib.ntu.edu.tw/handle/123456789/487357 |
ISSN: | 0008-543X | DOI: | 10.1002/cncr.21738 | SDG/Keyword: | cisplatin; doxorubicin; fluorouracil; folinic acid; gemcitabine; methotrexate; paclitaxel; vinblastine; adult; aged; alopecia; anemia; article; bladder tumor; blood toxicity; bone marrow suppression; cancer combination chemotherapy; clinical article; diarrhea; drug efficacy; febrile neutropenia; female; hand foot syndrome; human; infection; leukopenia; liver toxicity; male; metastasis; mucosa inflammation; nausea; nephrotoxicity; neurotoxicity; priority journal; stomatitis; thrombocytopenia; transitional cell carcinoma; urogenital tract tumor; urothelium; vomiting; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Cisplatin; Disease-Free Survival; Female; Fluorouracil; Humans; Infusions, Intravenous; Leucovorin; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Survival Rate; Treatment Outcome; Urinary Bladder Neoplasms |
Appears in Collections: | 腫瘤醫學研究所 |
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