Efficacy and safety of split-dose cisplatin neoadjuvant chemotherapy for muscl-einvasive bladder cancer
10.3969/j.issn.1009-8291.2025.10.005
- VernacularTitle:分剂量顺铂新辅助化疗用于肌层浸润性膀胱癌患者的疗效与安全性
- Author:
Kaikai CHEN
1
;
Jing LI
;
Hailong LIU
;
Ding XU
;
Shun ZHANG
;
Shenggen YU
;
Yu SHEN
;
Zhiwei CHEN
;
Haibo SHEN
Author Information
1. 上海交通大学医学院附属新华医院泌尿外科,上海 200092
- Publication Type:Journal Article
- Keywords:
muscl-einvasive bladder cancer;
gemcitabine;
cisplatin;
neoadjuvant chemotherapy;
split-dose administration;
nephrotoxicity
- From:
Journal of Modern Urology
2025;30(10):842-847
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of gemcitabine combined with conventional-dose cisplatin(70 mg/m2,day 2)versus split-dose cisplatin(35 mg/m2,days 1 and 8)in neo-adjuvant therapy for muscle-invasive bladder cancer(MIBC).Methods The clinical data of 33 MIBC patients receiving(gemcitabine+cisplatin,GC)-based neoadjuvant chemotherapy in the Department of Urology of Xinhua Hospital,during Jan.2021 and Aug.2024 were retrospectively analyzed,including 18(54.5％)patients treated with a conventional-dose regimen(GC group),and 15(45.5％)patients treated with a split-dose regimen(GCs group).The efficacy endpoints and incidence/severity of adverse reactions were compared between the two groups.Results Baseline characteristics were well-balanced between the two groups(P＞0.05).No significant differences were observed in the complete response rate(CR:33.3％vs.22.2％),objective response rate(ORR:66.7％vs.61.1％),or disease control rate(DCR:80.0％vs.88.9％)between the GCs and GC groups(P＞0.05).The GCs group exhibited a significantly lower incidence of chemotherapy-related renal injury(6.7％vs.38.9％,P＜0.05),while the occurrence of other adverse events was comparable between the two groups.Notably,the GCs group demonstrated significantly attenuated nephrotoxicity,as evidenced by markedly smaller changes in estimated glomerular filtration rate[eGFR:(4.5±4.7)％vs.(18.0±11.8)％]and serum creatinine[SCr:(5.7±5.6)％vs.(20.2±19.5)％]compared to the GC group(P＜0.05).Conclusion Compared with the conventional-dose regimen,the split-dose regimen maintains equivalent clinical efficacy of GC-based neoadjuvant chemotherapy while significantly reducing chemotherapy-related nephrotoxicity,thereby providing MIBC patients with a safer therapeutic option.
