TREATMENT OF ADVANCED UROGENITAL TRACT CANCERS WITH CIS-DIAMMINEDICHLOROPLATINUM

摘要

A total of 23 patients with urogenital tract cancers ... 17 non-seminomatous testicular cancers, 4 urinary bladder cancers, 1 renal pelvic cancer, and 1 penile cancer were treated with CDDP only or three-drug combination consisting of CDDP, vinblastine, and bleomycin. On the CDDP single therapy, platinum was given in a dosage of 25 mg/body as 2-hour intravenous infusion for 5 consecutive days in a week for 3 weeks. This treatment unit was repeated for 3 times. On the CDDP combination therapy, platinum was given in the same manner as the therapy with single CDDP, and vinblastine was given on the first and second days of 5 consecutive days in a week in a dosage of 10 mg/body for 3 weeks for 4 courses and then given as a single injection in a dosage of 10 mg/body for 4 weeks. This treatment was applied on and off for 2 years. Bleomycin was given weekly for 12 weeks in a dosage of 30 mg/body by intravenous injection. Three disseminated testicular cancers and one renal pelvic cancer were treated with CDDP. The therapy with CDDP single was not so effective for testicular cancers but a tumor regression was observed endoscopically in renal pelvic cancer. Fourteen disseminated testicular cancers, 4 urinary bladder cancers, and 1 penile cancer were treated with CDDP, vinblastine, and bleomycin given in combination. Two of the 14 testicular cancers (14%) achieved complete response and 5 of the 14 (36%) achieved partial response. But the 3-drug combination therapy was not so effective for urinary bladder cancer and penile cancer. On the toxicity of CDDP, the CDDP caused moderate to severe nausea and vomiting in almost of all patients during 5 days of treatment. None of these patients treated with CDDP showed nephrotoxity and ototoxity. But in the CDDP combination therapy, the most serious side effect is the myelosuppression due to vinblastine. Leukopenia (below 1,000/mm3) was observed in 5 of 19 patients. We believe the CDDP-combination therapy represents. a great advance in the management of patients with disseminated testicular cancer.