Combination chemotherapy for advanced urothelial-tract carcinoma

Summary

Between December 1982 and November 1990, 31 patients with advanced urothelial carcinoma were treated with one of two combination chemotherapy regimens. A total of 20 patients were treated with 3 mg/m² mitomycin C and 300 mg/m² cyclophosphamide given intravenously every 10–14 days and with 180 mg/m² 5-fluorouracil (5-FU) given intravenously every day for as long as possible (CF-Mito regimen). After the patient had been discharged from the hospital, the same treatment with CF-Mito was performed except that 180 mg/m² 5-FU was replaced by 400 mg/m² UFT (a mixture of tegafur and uracil) given orally. A total of 11 patients whose tumor had relapsed during the first-line treatment were given 60 mg/m² cisplatin, 40 mg/m² Adriamycin, and 40 mg/m² methotrexate intravenously every 28 days (PAM regimen). In all, 20 patients received 4–44 (mean, 9.7) courses of CF-Mito over a period of 1.5–24 (mean, 5.3) months. The results obtained in these 20 patients with evaluable lesions included no complete remission (CR), 4 partial remissions (PRs), 9 cases of stable disease (SD), and 7 cases of progressive disease (PD). The PR duration was 1.5–22 (mean, 7.5) months. The side effects encountered in this group included anorexia, nausea, vomiting, myelosuppression, diarrhea, stomatitis, liver damage, and heart failure. In all, 11 patients received 3–7 (mean, 4.1) courses of PAM over a period of 3–14.5 (mean, 5.2) months. All 11 patients had evaluable lesions, and their responses included no CR, 5 PRs, 3 cases of SD, and 3 cases of PD. The Pr duration was 1–3 (mean, 1.6) months. The side effects encountered in this group included anorexia, nausea, vomiting, myelosuppression, heart failure, and hair loss.