cis-Diamminedichloroplatinumを用いた進行性尿路性器悪性腫瘍に対する化学療法の検討

Abstract

Twenty eight patients with genitourinary carcinoma were treated with 50 to 75 mg cis-diamminedichloroplatinum (CDDP) per week for 6 to 8 weeks. The infusions were then spaced every 4 weeks thereafter. One patient with bladder carcinoma had primary lung cancer simultaneously and additional 5 patients had no measurable disease, leaving 22 patients, including II patients with urothelial tumor, 8 with prostatic cancer and 3 with testicular tumor evaluable for survival and response. In 11 patients with urothelial tumor 1 complete response, 5 partial response and 1 minor response were observed. A total objective response was seen in 6 of the 11 patients (54.5%). On the other hand only 2 partial responses (25%) were obtained among 8 patients with prostatic cancer. However severe pain due to bone metastasis was significantly decreased or disappeared in all patients and in this meaning, the CDDP therapy seemed to be clinically useful for these patients. All of 3 patients with testicular tumor showed partial objective response, a 100% response rate. Various degrees of nausea and vomiting were present in almost all patients during CDDP administration. Mild to moderate renal toxicity shown by an increase in serum BUN was observed in 6 patients (27.3%). Anemia less than 10 g/dl in the hemoglobin level was seen in 12 patients (54.5%), leucopenia less than 300/mm3 in 8 (36.4%) and thrombocytopenia less than 100, 000/mm3 in 7 (31.8%). Observation time to the following CDDP administration was prolonged until the patient would obtain sufficient recovery from such side effects. The myelosuppression appeared to be related to the cumulative effects of several doses of CDDP given to the patients. Anemia occurred after an average total dosage of 352 mg, leukopenia of 306 mg and thrombocytopenia of 286 mg. In conclusion, CDDP alone appears to be effective for the treatment of testicular tumors, prostatic and urothelial carcinomas. Combination with other drugs may further enhance its efficacy.