title: Effect of maintenance chemotherapy with gemcitabine and paclitaxel on recurrent squamous cell carcinoma of the bladder: a case report.
abstract: Squamous cell carcinoma (SCC) of the bladder is a relatively rare malignancy and the standard treatment is surgical resection. Prognosis of unresectable and recurrent SCC of the bladder is poor because no effective treatment is available at present. Here, we describe the response of one patient with this cancer to combination chemotherapy of gemcitabine and paclitaxel. A 47-year-old man with recurrent bladder SCC underwent radical cystectomy, but initially refused any adjuvant therapy. The pathological diagnosis was pT3. The patient was treated with three cycles of methotrexate, vinblastin, epirubicin, and cisplatin but with no response (no decrease in tumor volume). Subsequently, he received the combination chemotherapy of gemcitabine (GEM, 700 mg/m(2) on days 1 and 8) and paclitaxel (PTX, 700 mg/m(2) on days 1 and 8) per each 28-day cycle. After five cycles, the tumor volume had decreased from 562 to 101 cm(3) (18.0%). The combination therapy was reduced to GEM monotherapy, but the tumor volume increased to 573 cm(3). GEM+PTX administration was re-instituted; however, the patient died 21 months after recurrence. The combination GEM+PTX chemotherapy was applied at the outpatient treatment and caused no severe side-effects. Although the maintenance chemotherapy of GEM+PTX did not induce complete remission, it improved quality of life and had no serious side-effects, making it a promising combination chemotherapy for recurrent SCC of the bladder. Although further studies are necessary to determine its therapeutic efficacy, we suggest that this combined therapy is a useful option in the treatment of this disease including recurrent cases.
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. int.doc.miya@m3.dion.ne.jp
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Miyata
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Hajime
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sagara
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsuo
authors.forename: Kojiro
authors.initials: K
authors.lastname: Ohba
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakai
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D015653:Cystectomy / Q000379:methods; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015251:Epirubicin / Q000008:administration & dosage; D006801:Humans; D007564:Japan; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D015251:Epirubicin; D014747:Vinblastine; D017239:Paclitaxel; D002945:Cisplatin; D008727:Methotrexate; D000093542:Gemcitabine