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首页> 外文期刊>Urologic oncology >A cocktail regimen of intravesical mitomycin-C, doxorubicin, and cisplatin (MDP) for non-muscle-invasive bladder cancer
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A cocktail regimen of intravesical mitomycin-C, doxorubicin, and cisplatin (MDP) for non-muscle-invasive bladder cancer

机译：膀胱内丝裂霉素-C，阿霉素和顺铂（MDP）的鸡尾酒疗法用于非肌肉侵袭性膀胱癌

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Objective: To compare the efficacy and toxicity profiles of 3 intravesical regimens, including doxorubicin alone, bacillus Calmette-Guerin (BCG), and a cocktail regimen, in the prevention of bladder cancer recurrence. Materials and methods: Two hundred ninety patients with newly diagnosed non-muscle-invasive bladder cancer treated with transurethral resection (TUR) between March 1996 and December 2004 were analyzed retrospectively. Each cycle of the cocktail regimen contained 30 mg each of sequential weekly intravesical mitomycin-C (MMC), doxorubicin, and cisplatin (MDP). Two cycles of MDP were given within the first 6 weeks of TUR, followed by 1 cycle each at 3, 6, and 12 months, and every 6 months until 36 months after a negative cystoscopy. Doxorubicin and BCG alone was given at similar time points as the MDP and BCG protocols. Results: There were no demographic differences among the 3 groups. The median follow-up duration was 50 months. Dropout rates due to intolerance and/or poor compliance with the BCG, doxorubicin, and MDP protocols were 22.5%, 16.8%, and 11.0%, respectively. The MDP and BCG groups had similar bladder recurrence rates (37.9% vs. 33.9% at 5 years, respectively; P = 0.69). The doxorubicin group had significantly more recurrences than the BCG or MDP groups (HR = 1.9 (vs. BCG; P = 0.02) and 1.8 (vs. MDP; P = 0.01)). MDP was associated with less major adverse events than BCG (5.8% vs. 15.0%, respectively; P = 0.02). Conclusions: Compared with maintenance BCG, the MDP group had a similar recurrence rate but less side effects. Large randomized study is warranted to further determine the benefit of MDP adjuvant intravesical therapy.
机译：目的：比较3种膀胱内治疗方案（包括单独的阿霉素，卡介苗-卡介苗（BCG）和鸡尾酒疗法）在预防膀胱癌复发中的功效和毒性。材料与方法：回顾性分析了1996年3月至2004年12月间经尿道切除术（TUR）治疗的290例新诊断为非肌肉浸润性膀胱癌的患者。鸡尾酒疗法的每个周期分别包含连续的每周膀胱内丝裂霉素C（MMC），阿霉素和顺铂（MDP）30 mg。在TUR的前6周内进行了两个周期的MDP，然后在3、6和12个月分别进行1个周期，并在膀胱镜检查阴性后每6个月进行一次，直到36个月。仅在与MDP和BCG方案相似的时间点给予阿霉素和BCG。结果：3组之间没有人口统计学差异。中位随访时间为50个月。由于不耐受和/或对BCG，阿霉素和MDP方案的依从性差而导致的辍学率分别为22.5％，16.8％和11.0％。 MDP和BCG组的膀胱复发率相似（5年时分别为37.9％和33.9％; P = 0.69）。阿霉素组的复发率明显高于BCG或MDP组（HR = 1.9（vs。BCG; P = 0.02）和1.8（vs。MDP; P = 0.01））。与BCG相比，MDP的主要不良事件较少（分别为5.8％和15.0％; P = 0.02）。结论：与维持性卡介苗相比，MDP组的复发率相似，但副作用较少。大型随机研究有必要进一步确定MDP辅助膀胱内治疗的益处。

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