caa a22 4500 605490775 CHVBK 20210128100506.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10147-015-0846-z doi (NATIONALLICENCE)springer-10.1007/s10147-015-0846-z Sequential chemotherapy using gemcitabine+carboplatin followed by gemcitabine+carboplatin+docetaxel for advanced upper-tract urothelial cancer [Elektronische Daten] [Takahiro Yoneyama, Atsushi Imai, Shingo Hatakeyama, Yasuhiro Hashimoto, Takuya Koie, Chikara Ohyama] Background: Retrospective evaluation of the effectiveness and adverse events (AEs) of a sequential chemotherapy regimen using gemcitabine+carboplatin (GCarbo) followed by GCarbo+docetaxel (GCarboD) for advanced upper-tract urothelial carcinoma (UTUC). Methods: We treated 56 patients with advanced UTUC. Mean patient age was 68.9years, creatinine clearance was 51.2mL/min, and the observation period was 20months. Patients received two courses of GCarbo comprising 800mg/m2 gemcitabine on days 1, 8, and 15, and carboplatin at an area under the curve of four on day 2. If this regimen was effective, we administered two more courses of GCarbo; if the regimen was ineffective, we switched to two courses of GCarboD (70mg/m2). Results: Complete (n=3) and partial response (PR; n=25) were achieved after GCarbo. Mean response duration was 9.7months. Two of 17 cases achieved PR after GCarboD treatment (mean duration, 31.5months). Median survival was 14.0months with the GCarbo/GCarboD regimen. Responders to GCarbo therapy survived significantly longer. AEs with the GCarbo regimen included 31 instances of G3/4 blood toxicity and 8 instances of G3/4 urticaria; however, there were only 6 instances of G3/4 gastrointestinal complications. AEs with the GCarboD regimen included 16 instances of blood toxicity and 8 instances of gastrointestinal complications. Neither regimen resulted in G3/4 renal toxicity. Conclusions: GCarbo and GCarboD chemotherapy may be administered safely to patients with advanced UTUC, with or without renal dysfunction. Response to GCarbo was high (50.0%) whereas GCarboD was of limited effectiveness for non-responders to GCarbo. Japan Society of Clinical Oncology, 2015 Upper-urinary tract nationallicence Urothelial carcinoma nationallicence Carboplatin nationallicence Gemcitabine nationallicence Docetaxel nationallicence Yoneyama Takahiro Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut Imai Atsushi Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut Hatakeyama Shingo Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut Hashimoto Yasuhiro Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut Koie Takuya Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut Ohyama Chikara Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut International Journal of Clinical Oncology Springer Japan 20/6(2015-12-01), 1179-1184 1341-9625 20:6<1179 2015 20 10147 https://doi.org/10.1007/s10147-015-0846-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-015-0846-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yoneyama Takahiro Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut NATIONALLICENCE 700 1- Imai Atsushi Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut NATIONALLICENCE 700 1- Hatakeyama Shingo Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut NATIONALLICENCE 700 1- Hashimoto Yasuhiro Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut NATIONALLICENCE 700 1- Koie Takuya Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut NATIONALLICENCE 700 1- Ohyama Chikara Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, 036-8562, Hirosaki, Aomori, Japan aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/6(2015-12-01), 1179-1184 1341-9625 20:6<1179 2015 20 10147