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KMID : 0358319960370030293
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Korean Journal of Urology
1996 Volume.37 No. 3 p.293 ~ p.300
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Neoadjuvant M-VAC(Methotrexate, Vinblastine, Adriamycin and Cisplatin) Effect on the Invasive Bladder Tumor
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Abstract
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We evaluated the effect of M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) chemotherapy in 63 patients with invasive transitional cell carcinoma of the bladder between January 1987and December 1993. The patients consisted of 59 male
and
4
female. Patient age ranged from 35 to 80 years with a mean of 61.5 years. All patients were given 1-7 cycles(mean 2.7 cycles) of M-VAC chemotherapy and followed for 1 to 8 years.
Ten patients916%) achieved a clinical complete remission(CR), 22(35%) partial remission(PR), 11(17.5%) minor response(MR), 11(17.5%) stabilization(STAB), and 9(14%) progression(PROG). The overall clinical response rate was 51%. Of 22patients who
underwent surgery(radical cystectomy in 15, partectomy in 7), 3 patients(14%) achieved objective pathologic response. The estimated 5-year survival rate according to response of primary tumor to chemotherapy was 86%, 55% in patients with response
and
non-respectively. This difference between the groups was statistically significant(P<0.05). Overall 3-years and 5-yearss survival rates were 73% and 71%, respectively, and mean survival was 3.1 yeas. The toxicity of the regimen was generally
acceptable,
but 79% of the patients experienced myelosuppression, 8% hepatic toxicity and 6% stomatitis.
In conclusion, the patients who achieved a clinical response seem to have a better prognosis and neoadjuvant M-VAC chemotherapy may result in bladder preservation for selected patients with muscle invasive bladder cnacer.
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KEYWORD
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