Schedule-intensified M-VAC chemotherapy for advanced urothelial cancer with recombinant human granulocyte colony stimulating factor (rhG-CSF).
M-VAC (Methotrexate, vinblastine, adriamycin and cisplatin) combination systemic chemotherapy is useful for treating invasive or metastatic transitional cell carcinoma. Granulocytopenia is the major dose-limiting factor of this chemotherapy and it takes 4 weeks or more to complete a single course of M-VAC. We have tried to shorten the period of M-VAC chemotherapy from 4 to 3 weeks by using rhG-CSF. With this modified M-VAC regimen, the number of days on which the absolute neutrophil count was less than 1000/mm3 was significantly reduced and the period to reach the neutropenia nadir was shortened. No severe side-effects were observed. In all patients treated with 2 courses of this modified M-VAC short regimen, the period of hospitalization could be reduced by 2 weeks. We emphasize the possibility of shortening the M-VAC regimen.
Noguchi
S
S
Department of Urology, Yokohama City University, Kanagawa, Japan.
Kubota
Y
Y
Shuin
T
T
Hosaka
M
M
Miura
T
T
Kondoh
I
I
D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001855:Bone Marrow Diseases / Q000139:chemically induced; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D014571:Urologic Neoplasms / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects
D016179:Granulocyte Colony-Stimulating Factor; D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate