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

被引：0

作者：

Matsui, Yoshiyuki ^{[1
]}

Ogawa, Osamu ^{[1
]}

Ishitsuka, Ryutaro ^{[2
]}

Miyazaki, Jun ^{[2
]}

Inoue, Takamitsu ^{[3
]}

Kageyama, Susumu ^{[4
]}

Sugimoto, Mikio ^{[5
]}

Mitsuzuka, Koji ^{[6
]}

Shiraishi, Yusuke ^{[7
]}

Kinoshita, Hidefumi ^{[8
]}

Wakeda, Hironobu ^{[9
]}

Nomoto, Takeshi ^{[10
]}

Kikuchi, Eiji ^{[11
]}

Fujie, Keiko ^{[12
,13
]}

Keino, Naoto ^{[13
]}

Nishiyama, Hiroyuki ^{[2
]}

机构：

[1] Kyoto Univ, Grad Sch Med, Dept Urol, Kyoto 6068501, Japan

[2] Univ Tsukuba, Dept Urol, Fac Med, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan

[3] Akita Univ, Dept Urol, Grad Sch Med, Akita 0108502, Japan

[4] Shiga Univ Med Sci, Dept Urol, Otsu, Shiga 5202192, Japan

[5] Kagawa Univ, Dept Urol, Fac Med, Takamatsu, Kagawa 7610701, Japan

[6] Tohoku Univ, Dept Urol, Grad Sch Med, Sendai, Miyagi 9808575, Japan

[7] Hyogo Coll Med, Dept Urol, Nishinomiya, Hyogo 6638501, Japan

[8] Kansai Med Univ, Dept Urol & Androl, Osaka 5731191, Japan

[9] Miyazaki Univ, Dept Urol, Fac Med, Miyazaki 8891692, Japan

[10] Tokai Univ, Dept Urol, Sch Med, Hiratsuka, Kanagawa 2591193, Japan

[11] Keio Univ, Dept Urol, Sch Med, Tokyo 1608582, Japan

[12] Univ Tsukuba, Fac Med, Tsukuba, Ibaraki 3058575, Japan

[13] Univ Tsukuba, Tsukuba Clin Res & Dev Org, Tsukuba, Ibaraki 3058575, Japan

来源：

International Journal of Clinical Oncology | 2016年 / 21卷 / 06期

关键词：

Urothelial cancer; Elderly; Systemic chemotherapy; Outcome; Renal function; BLADDER-CANCER; CISPLATIN; CARCINOMA; METHOTREXATE; VINBLASTINE; DOXORUBICIN;

D O I：

10.1007/s10147-016-1007-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：1142 / 1149

页数：8

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