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Outcome of maintenance systemic chemotherapy with drug-free interval for metastatic urothelial carcinoma

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Title: Outcome of maintenance systemic chemotherapy with drug-free interval for metastatic urothelial carcinoma
Authors: Abe, T. Browse this author →KAKEN DB
Minami, K. Browse this author
Harabayashi, T. Browse this author
Sazawa, A. Browse this author
Chiba, H. Browse this author
Kikuchi, H. Browse this author
Miyata, H. Browse this author
Matsumoto, R. Browse this author
Osawa, T. Browse this author
Maruyama, S. Browse this author
IshizakiIshizaki, J. Browse this author
Mochizuki, T. Browse this author
Chiba, S. Browse this author
Akino, T. Browse this author
Murakumo, M. Browse this author
Miyajima, N. Browse this author
Tsuchiya, K. Browse this author
Murai, S. Browse this author
Shinohara, N. Browse this author →KAKEN DB
Keywords: metastatic urothelial carcinoma
systemic chemotherapy
maintenance chemotherapy
Issue Date: Oct-2019
Publisher: Oxford University Press
Journal Title: Japanese journal of clinical oncology
Volume: 49
Issue: 10
Start Page: 965
End Page: 971
Publisher DOI: 10.1093/jjco/hyz084
Abstract: Objective: Aiming to achieve long-term disease control, maintenance systemic chemotherapy (MSC) with a 1-3-month drug-free interval is continued in selected patients. We report our experience of MSC for metastatic urothelial carcinoma (UC). Methods: Of 228 metastatic UC patients treated with systemic chemotherapy, 40 (17.5%, 40/228) had continuously undergone MSC. Data on the regimen, cycle number, and reason for the discontinuation of MSC were also collected. We analyzed OS from the initiation of MSC until death or the last follow-up, using the log-rank test to assess the significance of differences. Results: The median number of cycles of chemotherapy was 6, and the responses were CR in 6, PR in 20, SD in 13, and PD in 1 before MSC. Gemcitabine plus CDDP or carboplatin was mainly performed as MSC (70%, 28/40). MSC was repeated quarterly in 30 (75%, 30/40), every two months in 8 (20%, 8/40), and with other intervals in 2 (5%, 2/40). Overall, a median of 3.5 cycles (range: 1-29) of MSC was performed. The reason for the discontinuation of MSC was PD in 24 (60%, 24/40), favorable disease control in 9 (22.5%, 9/40), and myelosuppression in 3 (7.5%, 3/40), and for other reasons in 2 (5%, 2/40). MSC was ongoing in 2 (5%, 2/40). The median OS was 27 months from the initiation of MSC. PS0 (P = 0.0169), the absence of lung metastasis (P = 0.0387), and resection of the primary site (P = 0.0495) were associated with long-term survival after MSC. Conclusions: In selected patients, long-term systemic chemotherapy could be performed with a drug-free interval. Our maintenance strategy with cytotoxic drugs may become one of the treatment options for long-term disease control.
Rights: http://creativecommons.org/licenses/by-nc/ 4.0/
Type: article
URI: http://hdl.handle.net/2115/76801
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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