Eryn B Callihan, Elizabeth Molina Kuna, Corbin J Eule, Elizabeth R Kessler, Thomas W Flaig
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引用次数: 0
Abstract
Background: The practice patterns and efficacy of ddMVAC administered with split-dose cisplatin for patients with muscle-invasive bladder cancer (MIBC) remains largely undefined.
Objective: To characterize the application and overall survival (OS) in patients with MIBC receiving conventional ddMVAC versus split-dosed ddMVAC and to examine the predictive variables in those receiving split-dosed cisplatin.
Methods: Using data from the CancerLinQ Discovery database, we identified 626 patients with bladder cancer between 2000-2023 with receipt of ddMVAC. The primary outcome was OS by receipt of split-dose versus conventional ddMVAC. A secondary outcome of interest assessed predictors of receipt of split-dose ddMVAC. Use of split-dose versus conventional ddMVAC was compared using chi-square tests. Univariate and multivariable OS were estimated using Cox proportional hazards models. Predictors of receipt of split dose versus conventional ddMVAC were estimated using logistic regression models.
Results: Most patients with MIBC are treated with standard dose ddMVAC. In multivariate analysis, no statistically significant difference in OS was observed between split-dose and conventional ddMVAC (HR 1.3, CI 0.78-2.18, p = 0.316). We demonstrate a notable decline in the use of split-dose cisplatin over time. Baseline GFR and performance status were not predictors of split-dosing in this cohort.
Conclusions: Most patients with MIBC received conventional ddMVAC with decreasing frequency of split-dose cisplatin use over time. We did not observe a difference in OS between patients with MIBC who received standard versus split-dose cisplatin.
背景：ddMVAC联合分剂量顺铂治疗肌肉浸润性膀胱癌（MIBC）的实践模式和疗效在很大程度上仍未明确。目的：比较常规ddMVAC与分次ddMVAC在MIBC患者中的应用和总生存期（OS），并研究分次顺铂患者的预测变量。方法：使用来自CancerLinQ Discovery数据库的数据，我们确定了2000-2023年间接受ddMVAC治疗的626例膀胱癌患者。主要终点是接受分次剂量与常规ddMVAC的总生存率。次要结果评估了接受分剂量ddMVAC的预测因素。使用卡方检验比较了分剂量与常规ddMVAC的使用情况。使用Cox比例风险模型估计单变量和多变量OS。使用逻辑回归模型估计分离剂量与常规ddMVAC的预测因子。结果：大多数MIBC患者采用标准剂量ddMVAC治疗。在多因素分析中，分次给药与常规ddMVAC的OS差异无统计学意义（HR 1.3, CI 0.78 ~ 2.18, p = 0.316）。随着时间的推移，我们证明了分剂量顺铂使用的显著下降。在这个队列中，基线GFR和运动状态不是分开给药的预测因素。结论：大多数MIBC患者接受常规ddMVAC治疗，顺铂分剂量使用频率随着时间的推移而降低。我们没有观察到接受标准剂量顺铂与分剂量顺铂治疗的MIBC患者的OS差异。
期刊介绍：
Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.
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