Gemcitabine and docetaxel as second-line chemotherapy in elderly patients with metastatic urothelial carcinoma: a retrospective analysis.
Gemcitabine and docetaxel as second-line chemotherapy in elderly patients with metastatic urothelial carcinoma: a retrospective analysis.
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DOI：
10.2147/cmar.s172913
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发表时间：
2018
影响因子：
3.3
通讯作者：
Yasui T
中科院分区：
文献类型：
--
作者：
Naiki T;Iida K;Etani T;Nagai T;Tanaka Y;Sugiyama Y;Ando R;Hamamoto S;Banno R;Nagata D;Kawai N;Yasui T
本研究的目的是评价吉西他滨联合多西他赛（GD）作为老年转移性尿路上皮癌（mUC）患者二线治疗的疗效。2010年7月至2016年6月，共有122例既往接受过含铂化疗的mUC患者接受了二线GD治疗。这包括在每个21天周期的第1天和第8天给予800 mg/m2吉西他滨和40 mg/m2多西他赛。使用汇总的累积数据，我们根据年龄将患者分为以下三组：<65岁（A组），65 - 74岁（B组）和≥75岁（C组），然后对数据进行回顾性分析。对所有患者进行治疗相关毒性评价，并在每个周期通过影像学研究进行评估。Kaplan-Meier曲线用于生存和复发分析。此外，通过单变量和多变量考克斯回归分析评估了无进展生存期（PFS）和总生存期（OS）的潜在预后因素。中位随访期为8.2个月（范围：2.1-100）。A组的中位治疗周期数为3个（范围：1-16），B组为3个（1-15），C组为2个（1-11）。三组之间的客观缓解率无显著差异。此外，从二线GD治疗开始的PFS和OS也无显著差异。根据二线GD治疗队列的单变量和多变量分析，良好的体能状态是PFS和OS的唯一预后因素。在C组中，骨髓抑制（包括主要的中性粒细胞减少和贫血）、疲乏和恶心是主要的常见不良事件。然而，中性粒细胞减少和血小板减少的发生率在三组之间没有显著差异。本研究中未发生治疗相关死亡。在这项研究中，GD联合治疗作为mUC的二线治疗，即使在老年患者中，也产生了良好的肿瘤缓解和很少的治疗相关毒性。
The objective of this study was to evaluate the efficacy of a combination of gemcitabine and docetaxel (GD) as a second-line treatment for elderly patients with metastatic urothelial carcinoma (mUC). A total of 122 patients with mUC who were previously treated with platinum-based chemotherapy received second-line GD therapy from July 2010 to June 2016. This consisted of 800 mg/m2 gemcitabine and 40 mg/m2 docetaxel on days 1 and 8 in each 21-day cycle. Using pooled cumulative data, we divided patients into the following three groups based on age: <65 years (Group A), from 65 to 74 years (Group B), and ≥75 years (Group C), and then the data were retrospectively analyzed. All patients were evaluated for treatment-related toxicities and assessed at every cycle by imaging studies. Kaplan–Meier curves were used for survival and recurrence analyses. Furthermore, potential prognostic factors for progression-free survival (PFS) and overall survival (OS) were assessed via univariate and multivariate Cox regression analyses. The median follow-up period was 8.2 months (range: 2.1–100). The median number of treatment cycles was three (range: 1–16) in Group A, three (1–15) in Group B, and two (1–11) in Group C. The objective response rate was not significantly different between the three groups. In addition, PFS and OS from the start of second-line GD therapy were also not significantly different. According to univariate and multivariate analyses of the second-line GD-treated cohort, a good performance status was the only prognostic factor for PFS and OS. In Group C, myelosuppression including predominant neutropenia and anemia, fatigue, and nausea were the main common adverse events. However, the incidence of neutropenia and a reduction in platelets were not significantly different between the three groups. Treatment-related deaths did not occur in this study. In this study, GD combination therapy as a second-line treatment for mUC resulted in favorable tumor responses and few treatment-related toxicities, even among elderly patients.