進行性尿路上皮癌に対するM-EAP(Methotrexate,Etoposide,AdriamycinおよびCisplatin)療法の経験

Abstract

M-VAC療法のVBLをVP-16に変更したM-EAP療法を, 4例の尿路上皮癌患者に施行した.1)評価可能病変を有する3例ではCR 1例, PR 2例.2) 70%濃度の投与量でもCRが1例に得られた.3) 4例中2例はM-EAP療法終了後, 5ヵ月目で癌死した.4) M-EAP療法は尿路上皮癌に有効であると思われるが, 生存期間の延長に寄与するか否かは今後の検討を要する

Combination chemotherapy with methotrexate, etoposide, adriamycin and cisplatin (M-EAP regimen) was administered to 4 patients with advanced epithelial cancer of the urinary tract (Methotrexate 30 mg/M2 day 1, 15 and 22; Etoposide 100 mg/M2 day 1, 2, 15 and 22; Adriamycin 30 mg/M2 day 2; Cisplatin 70 mg/M2 day 2, every 4 weeks). In an attempt to improve the anti-cancer effect of the M-VAC regimen, etoposide was substituted for vinblastine. This series comprised 3 males and 1 female ranging in age from 54 to 68 years (mean age: 63), with a performance status of 1 to 2. The site of the primary lesion was bladder in 3, and left ureter in 1. The clinical response was assessed in 3 of the 4 patients: one achieved complete response and two had partial response. Two of the four died of disease 5 months after chemotherapy. Two of them have been alive for 10 and 8 months with no evidence of disease after chemotherapy. Toxicity included moderate or severe myelosuppression in two patients, and mild to moderate anorexia, vomiting, alopecia, and hiccups in all patients. These preliminary results suggest that the M-EAP regimen is effective against advanced epithelial carcinoma of the urinary tract. However, myelosuppression was a dose-limiting factor.