Japanese Journal of Clinical Oncology, Vol 28, Issue 8 497-501, Copyright © 1998 by Foundation for Promotion of Cancer Research
M Kuroda, T Kotake, H Akaza, S Hinotsu and T Kakizoe
BACKGROUND: To evaluate the antitumor activity in patients with T3b, T4 or
metastatic urothelial carcinoma treated with MEC or M-VAC chemotherapy, by
performing a multi-center randomized prospective study. METHODS: From 1991
to 1995, 89 patients with T3b, T4 or metastatic urothelial carcinoma were
randomly allocated to a methotrexate, epirubicin and cisplatin chemotherapy
group (arm 1: S-MEC therapy; n = 29), a dose-intensified MEC therapy
combined with G-CSF group (arm 2: I-MEC therapy; n = 30) or a methotrexate,
vinblastine, doxorubicin and cisplatin chemotherapy (arm 3: M-VAC therapy;
n = 30). At the registration center, the patients were stratified into
previously untreated patients and patients with recurrence after radical
operation and then randomly allocated to the treatment groups. In each arm,
two or more courses of chemotherapy (4-week cycles) were performed.
RESULTS: Of the 88 eligible patients, four treated with S-MEC therapy and
two treated with I-MEC therapy showed CR. The response rates (CR + PR) were
52% (15/29) with S-MEC therapy, 76% (22/29) with I-MEC therapy and 47%
(14/30) with M-VAC therapy. The response rate with I-MEC therapy was
significantly higher than that with M-VAC therapy (P = 0.02). Although the
incidence of leukopenia was low with I-MEC therapy, the incidence of
thrombocytopenia was high with this therapy. CONCLUSION: MEC therapy used
in this study is promising in terms of the antitumor effects.
CASE REPORTS
Efficacy of dose-intensified MEC (methotrexate, epirubicin and cisplatin) chemotherapy for advanced urothelial carcinoma: a prospective randomized trial comparing MEC and M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin). Japanese Urothelial Cancer Research Group
Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
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