NEOADJUVANT (PREEMPTIVE) CISPLATIN THERAPY IN INVASIVE TRANSITIONAL CELL-CARCINOMA OF THE BLADDER
NEOADJUVANT (PREEMPTIVE) CISPLATIN THERAPY IN INVASIVE TRANSITIONAL CELL-CARCINOMA OF THE BLADDER
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DOI：
10.1111/j.1464-410x.1991.tb15225.x
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发表时间：
1991-06-01
期刊：
影响因子：
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通讯作者：
LATIEF, T
中科院分区：
文献类型：
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作者：
WALLACE, DMA;RAGHAVAN, D;LATIEF, T
2项初步研究显示，在确定性治疗之前，静脉内顺铂治疗膀胱移行细胞癌的反应率为57%和61%，西米德兰兹泌尿学研究组（WMURG）和澳大利亚膀胱癌研究组（ABCSG）独立开始了随机试验，以测试T2-T4 MO膀胱移行细胞癌，两项试验均未能在西米德兰兹郡招募250例患者，在澳大利亚招募320例患者。 由于他们有相似的治疗方案和合格性标准，因此将他们合并在一个概述分析中，总共达到255例患者。每个治疗组与其自己的对照组进行比较，并将差异汇总以给出总体结果。 治疗组和对照组患者的生存率无差异。 优势比为1.13，对照组略优于化疗组。 即使有255例患者，比值比的95%置信区间也很宽（0.80-1.57）。 虽然没有明确的证据表明新辅助顺铂有临床价值的获益，但必须在一项更大规模的研究中使用对转移性疾病具有更大活性的联合治疗来测试这种方法。
Following 2 pilot studies which showed 57 and 61% response rates to intravenous cisplatin for transitional cell carcinoma of the bladder prior to definitive treatment, the West Midlands Urological Research Group (WMURG) and the Australian Bladder Cancer Study Group (ABCSG) independently began randomised trials to test the survival benefit of neo-adjuvant intravenous cisplatin prior to radiotherapy in T2-T4 MO transitional cell carcinoma of the bladder.Both trials failed to recruit their target numbers of 250 patients in the West Midlands and 320 in Australia. Since they had similar treatment protocols and eligibility criteria, they were combined in an overview analysis, achieving a total number of 255 patients.Each treatment group was compared with its own control group and the differences were pooled to give an overall result. There was no difference in survival between treated and control patients. The odds ratio was 1.13 with the control groups faring marginally better than the chemotherapy groups. Even with 255 patients the 95% confidence interval of the odds ratio was wide (0.80-1.57). Although there is no clear evidence of a clinically worthwhile benefit from neo-adjuvant cisplatin, this approach must be tested in a larger study using combination treatments with greater activity in metastatic disease.