Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightA higher median PFS was obtainedin patients who were <65 year-olds, without organ metastasis with objective response rate, however, itwas statistically insignificant.Conclusion: Gemcitabine maintenance therapy in metastatic bladder cancer patients who did not shown progressionafter the standard platinum-gemcitabine treatment contributes to survival and presents low toxicityprofile, when compared to historical controls
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Özet
Objective: To investigate the effects of gemcitabine maintenance treatment on survival in patients with metastaticbladder cancer.Material and methods: Gemcitabine maintenance monotherapy was administered following the standardplatinum-gemcitabine therapy in patients with metastatic bladder cancer. Patients who had responded to standardtreatment received maintenance gemcitabine therapy as 1000 mg/m2 on days 1 and 8 every three weeksuntil progression or development of unacceptable toxicity. The following clinical factors were noted: performancestatus, age, sex, stage, site of metastasis, choice of cisplatin-gemcitabine or carboplatin-gemcitabine,response rates to the initial chemotherapy. Progression- free survival (PFS) and overall survival (OS) for standardtreatment, and following gemcitabine monotreatment and for maintenance gemcitabine therapy werecalculated using Kaplan–Meier method.Results: A total of 88 patients with metastatic bladder cancer treated between February 2009 to October2015 were evaluated retrospectively and 23 patients (26.1%) who had responded to six cycles of platinumgemcitabinetreatment were included in this study. Maintenance gamcitabine was administered for a medianof 7 times (range 3–14 times). Grade 3 hematotoxicity according to the criteria of the Common TerminologyCriteria of Adverse Events was observed in 7 (30.4%) patients. Median PFS of patients was 46 (range: 30-82)weeks for platinum-based treatment plus maintenance gemcitabine therapy. A higher median PFS was obtainedin patients who were <65 year-olds, without organ metastasis with objective response rate, however, itwas statistically insignificant.Conclusion: Gemcitabine maintenance therapy in metastatic bladder cancer patients who did not shown progressionafter the standard platinum-gemcitabine treatment contributes to survival and presents low toxicityprofile, when compared to historical controls
Abstract
Amaç: Metastatik mesane kanserli hastalarda, idame gemsitabin tedavisinin sağkalım üzerindeki etkisini araştırmak. Gereç ve yöntemler: Gemsitabine idame tedavisi, metastatik mesane kanserli hastalara, standart platin-gemsitabin tedavisinin ardından uygulandı. Standart tedaviye yanıtı olan hastalar, idame gemsitabin tedavisini 1000 mg/m2, 1. ve 8. gün 3 haftada 1 olmak üzere, progresyona ya da kontrol edilemeyen toksisiteye gelişinceye kadar aldı. Şu klinik faktörler not edildi: yaş, cinsiyet, metastaz bölgesi, sisplatin-gemsitabin ya da karboplatin- gemsitabin seçimi ve ilk tedaviye cevap oranı. Standart tedavi ve sonrası verilen gemsitabin için ve sadece idame gemsitabin için progresyonsuz sağkalım (PSK) ve genel sağkalım (GS), "Kaplan-Meier yöntemi" kullanılarak hesaplandı. Bulgular: Şubat 2009 ile Ekim 2015 yılları arasında 88 metastatik mesane kanserli hasta retrospektif olarak tarandı ve çalışmaya 6 kür platinum-gemsitabin tedavisine cevaplı 23 hasta (%26,1) dahil edildi. İdame gemsitabinin median uygulanma sayısı 7 (3-14) idi. "Common Terminology Criteria of Adverse Events" kriterlerine göre 3. derece hematoksisite, 7 hastada (%30,4) gözlendi. Platin bazlı tedavi ve idame gemsitabin için median PSK 46 hafta (30-82), sadece idame gemsitabin için 22 hafta (10-56) idi. 65 yaş altı, objektif cevap oranı sergileyen ve organ metastazı olmayan hastalarda, daha yüksek median PSK süresi elde edildi fakat bu istatistiki olarak anlamlı değildi. Sonuç: Standart platinum bazlı tedavi sonrası progrese olmayan hastalarda idame gemsitabin tedavisi, tarihi kontrolleri ile kıyaslandığında, metastatik mesane kanserinde sağkalıma katkıda bulunur ve düşük bir toksisite profili vardır.