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Abstract：
OBJECTIVE: In recent years, switch maintenance after platinum-based chemotherapy has been a standard of care. However, the appropriate number of systemic chemotherapy cycles against advanced-stage urothelial carcinoma (UC) remains unclear. This study assessed the survival outcomes of first-line platinum-based chemotherapy according to treatment cycles in patients with metastatic disease.
METHODS: We retrospectively evaluated patients with metastatic bladder and upper urinary tract cancer who received platinum-based combination therapy. Overall survival (OS) was evaluated using the Kaplan-Meier method and the log-rank test.
RESULTS: Of 179 patients, 47 (26.3%) were women, and 73 (40.8%) had upper urinary tract cancer. Furthermore, 47 (26.3%) who were not eligible for cisplatin received carboplatin. The median number of treatment cycles was 3 (range=1-14 cycles). The rates of progressive disease within two cycles, from two to four cycles, and from four to six cycles were 18.4%, 19.2%, and 30.6%, respectively. The median OS of patients with 2, 3, 4, 5-6, and ≥7 treatment cycles were 8.6, 14.3, 21.3, 24.4, and 26.1 months, respectively. The OS did not significantly differ between patients receiving four treatment cycles and those receiving ≥5 treatment cycles. In patients with disease control (complete or partial response or stable disease) receiving ≥4 treatment cycles, there was no significant difference in terms of OS between patients receiving four cycles and those receiving six cycles.
CONCLUSIONS: Four cycles of first-line platinum-based chemotherapy can be effective in patients with metastatic UC.
METHODS: We retrospectively evaluated patients with metastatic bladder and upper urinary tract cancer who received platinum-based combination therapy. Overall survival (OS) was evaluated using the Kaplan-Meier method and the log-rank test.
RESULTS: Of 179 patients, 47 (26.3%) were women, and 73 (40.8%) had upper urinary tract cancer. Furthermore, 47 (26.3%) who were not eligible for cisplatin received carboplatin. The median number of treatment cycles was 3 (range=1-14 cycles). The rates of progressive disease within two cycles, from two to four cycles, and from four to six cycles were 18.4%, 19.2%, and 30.6%, respectively. The median OS of patients with 2, 3, 4, 5-6, and ≥7 treatment cycles were 8.6, 14.3, 21.3, 24.4, and 26.1 months, respectively. The OS did not significantly differ between patients receiving four treatment cycles and those receiving ≥5 treatment cycles. In patients with disease control (complete or partial response or stable disease) receiving ≥4 treatment cycles, there was no significant difference in terms of OS between patients receiving four cycles and those receiving six cycles.
CONCLUSIONS: Four cycles of first-line platinum-based chemotherapy can be effective in patients with metastatic UC.
摘要：
目的：近年来，铂类化疗后的转换维护已成为标准护理。然而,针对晚期尿路上皮癌(UC)的合适的全身化疗周期数仍不清楚.本研究根据转移性疾病患者的治疗周期评估一线铂类化疗的生存结果。
方法：我们回顾性评估了接受铂类联合治疗的转移性膀胱和上尿路癌患者。使用Kaplan-Meier方法和对数秩检验评估总生存期(OS)。
结果：在179名患者中，47人（26.3%）是女性，73例(40.8%)患有上尿路癌。此外，47例（26.3%）不符合顺铂治疗条件的患者接受了卡铂治疗。治疗周期的中位数为3（范围=1-14个周期）。两个周期内进行性疾病的发生率，从两到四个周期，四到六个周期为18.4%，19.2%,和30.6%，分别。2、3、4、5-6和≥7个治疗周期的患者的中位OS分别为8.6、14.3、21.3、24.4和26.1个月，分别。接受四个治疗周期的患者和接受≥5个治疗周期的患者之间的OS没有显着差异。在疾病控制（完全或部分缓解或疾病稳定）接受≥4个治疗周期的患者中，接受4个周期的患者和接受6个周期的患者在OS方面没有显著差异.
结论：4个周期的一线铂类化疗对转移性UC患者有效。
方法：我们回顾性评估了接受铂类联合治疗的转移性膀胱和上尿路癌患者。使用Kaplan-Meier方法和对数秩检验评估总生存期(OS)。
结果：在179名患者中，47人（26.3%）是女性，73例(40.8%)患有上尿路癌。此外，47例（26.3%）不符合顺铂治疗条件的患者接受了卡铂治疗。治疗周期的中位数为3（范围=1-14个周期）。两个周期内进行性疾病的发生率，从两到四个周期，四到六个周期为18.4%，19.2%,和30.6%，分别。2、3、4、5-6和≥7个治疗周期的患者的中位OS分别为8.6、14.3、21.3、24.4和26.1个月，分别。接受四个治疗周期的患者和接受≥5个治疗周期的患者之间的OS没有显着差异。在疾病控制（完全或部分缓解或疾病稳定）接受≥4个治疗周期的患者中，接受4个周期的患者和接受6个周期的患者在OS方面没有显著差异.
结论：4个周期的一线铂类化疗对转移性UC患者有效。
