Tolerability of Gemcitabine Plus Cisplatin for Treatment of Urothelial Cancer in the Elderly Population
Tolerability of Gemcitabine Plus Cisplatin for Treatment of Urothelial Cancer in the Elderly Population
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DOI：
10.1016/j.clgc.2015.09.003
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发表时间：
2016-06-01
影响因子：
3.2
通讯作者：
Gupta, Shilpa
中科院分区：
文献类型：
--
作者：
Jan, Anna S.;Dolan, Dawn E.;Gupta, Shilpa
吉西他滨联合顺铂治疗年龄≥ 65岁的尿路上皮癌患者的最佳剂量尚不清楚。我们回顾了28例患者的数据，其中大多数接受吉西他滨联合顺铂的新辅助治疗。最常用的剂量是吉西他滨1250 mg/m2，第1天和第8天给药，顺铂70 mg/m2，第1天给药，每21天一次。吉西他滨1000 mg/m2的较低剂量耐受性更好，治疗延迟更少。背景：吉西他滨联合顺铂是转移性尿路上皮癌的标准治疗，也常用于新辅助治疗和辅助治疗。然而，年龄≥ 65岁患者的最佳剂量和时间表尚不清楚。患者和方法：我们进行了一项回顾性研究，以确定吉西他滨联合顺铂治疗老年人尿路上皮癌的耐受性。本研究共纳入28例年龄≥ 65岁的尿路上皮癌患者，从2008年1月1日至2013年8月31日接受吉西他滨联合顺铂21天方案治疗。结果：28例患者中，16例（57.1%）在新辅助治疗中接受吉西他滨联合顺铂。最常见的给药方案是吉西他滨1250 mg/m2，第1天和第8天给药，顺铂70 mg/m2，第1天，每21天给药一次，有些患者接受吉西他滨1000 mg/m2。吉西他滨剂量增加导致剂量调整和治疗延迟的主要原因是血液学毒性。两名患者因肾功能不全而停止治疗，其中一名患者出现4级血清肌酐升高。1例患者发生发热性中性粒细胞减少症;然而，该患者未接受生长因子支持作为发热性中性粒细胞减少症的一级预防。结论：对于年龄≥ 65岁的患者，吉西他滨联合顺铂总体上是一种耐受性良好的治疗方案。本研究的结果支持使用较低剂量的吉西他滨1000 mg/m2，因为它的耐受性更好。(C)2015 Elsevier Inc. All rights reserved.
The optimal dosing of gemcitabine plus cisplatin for urothelial cancer in patients aged >= 65 years is unknown. We reviewed the data from 28 patients, most of whom received gemcitabine plus cisplatin in the neoadjuvant setting. The most common dose used was gemcitabine 1250 mg/m(2) given on days 1 and 8 plus cisplatin 70 mg/m(2) on day 1 every 21 days. A lower gemcitabine dose of 1000 mg/m(2) was better tolerated with fewer treatment delays.Background: Gemcitabine plus cisplatin is the standard of care for metastatic urothelial cancer and is frequently used in the neoadjuvant and adjuvant setting as well. However, the optimal dose and schedule for patients aged >= 65 years is not clear. Patients and Methods: We performed a retrospective study to determine the tolerability of gemcitabine plus cisplatin for treatment of urothelial cancer in the elderly population. A total of 28 patients aged >= 65 years with urothelial cancer treated with gemcitabine plus cisplatin on a 21-day schedule from January 1, 2008 to August 31, 2013 were included in the present study. Results: Of the 28 patients, 16 (57.1%) received gemcitabine plus cisplatin in the neoadjuvant setting. The most common dosing regimen was gemcitabine 1250 mg/m(2) given on days 1 and 8 plus cisplatin 70 mg/m(2) on day 1 every 21 days, with some receiving gemcitabine at a dose of 1000 mg/m(2). The primary reason behind the dose modifications and treatment delays with the higher gemcitabine dose was hematologic toxicity. Two patients discontinued treatment because of renal dysfunction, with one developing a grade 4 elevation in serum creatinine. One patient developed febrile neutropenia; however, this patient did not receive growth factor support for primary prophylaxis of febrile neutropenia. Conclusion: Gemcitabine plus cisplatin overall is a reasonably well-tolerated treatment regimen for patients aged >= 65 years. The results of the present study support the use of a lower gemcitabine dose of 1000 mg/m(2), because it was better tolerated. (C) 2015 Elsevier Inc. All rights reserved.