ABSTRACT
We retrospectively reviewed 57 patients with advanced urothelial transitional cell carcinomas who were treated with methotrexate, vinblastine, doxorubicin and cisplatin(M-VAC) chemotherapy, in 45 patients, and cisplatin, cyclophosphamide and doxorubicin(CISCA) chemotherapy, in 12 patients. The complete response rate of total patients was 14%(8/57 patients) and the partial response rate was 30%(17/57). The response rates according to lesion sites were 56.7%(17/31) in bladder, 50%(1/2) ureter, 50%(4/8) lung, 42%(15/35) lymph node, 25%(1/4) renal pelvis and 25%(3/12) bone. The mean response period was 8.1 months in complete response group and 6.8 months in partial response group. The response rates(in M-VAC/CISCA) according to primary lesion sites were 50%/25% in bladder, 40%/50% in renal pelvis and 0%/50% in ureter and statically significant differences were not noticed in response rates(p>0.05). The response rates in M-VAC and CISCA chemotherapy groups were 47%(21/45), 33%(4/12) but statistically significant differences were not noticed in response rates (p>0.05). The 3-year survival rates were 29% in M-VAC chemotherapy group and 8% in CISCA and the 3-year survival rates of response groups were 57% in M-VAC chemotherapy group and 25% in CISCA, but they were not related statistically(p>0.05). In comparison of drug toxicity, toxic symptoms were seen mostly in M-VAC chemotherapy group and most common symptom was bone marrow suppression. In conclusion, the response & survival rates between M-VAC and CISCA chemotherapy groups were not related statistically(p>0.05), but the response & survival rates of M-VAC chemotherapy group were generally superior than CISCA chemotherapy group.