机构：[1]Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China[2]Department of Urology, Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China[3]West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China[4]West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
We conducted a meta-analysis to assess the efficacy and safety of dose-dense chemotherapy in the treatment of patients with urothelial carcinoma. A systematic search was conducted in PubMed, Medline, Embase, Web of Science and Cochrane Collaboration's Central register of controlled trials (CENTRAL) for relevant articles. Data was obtained from 10 trials with a total of 1093 patients. The pooled pathologic complete response (pCR) was 27.8% in the ten studies with a full cohort of 684 patients who received dose-dense methotrexate, vinblastine, adriamycin and cisplatin (dd-MVAC). In the controlled trials, although the difference was not significant, the pCR rate in the dd-MVAC group has a trend of increase (odds ratio (OR) 1.52; 95% confidence interval (CI) 0.78-2.98, P = 0.22) compared with classic MVAC group. A significant improvement of overall survival (OS) (hazard ratio (HR) 0.77, 95% CI 0.61-0.97, p = 0.03) was also observed. Hematologic toxicities were the most frequent grade ≥ 3 toxicities including neutropenia/febrile neutropenia (17.5%), anemia (9.4%) and thrombocytopenia (6.1%). Compared with the classic MVAC group, dd-MVAC was associated with significantly decreased risks of all-grade adverse events (AEs) such as anemia (OR 0.457, 95% CI 0.249-0.840, p = 0.012), febrile neutropenia (OR 0.398 95% CI 0.233-0.681, p = 0.001), and neutropenia (OR 0.373, 95% CI 0.201-0.691, p = 0.002). In conclusion, dose-dense chemotherapy was effective and tolerable in patients with urothelial carcinoma, which could be considered as a reasonable therapeutic option.
基金：
Administration of Traditional Chinese Medicine of Sichuan [2014K158]; Science and Technology Administration, Sichuan Province [2017SZ0048, 2014SZ0031]; Health and Family Planning Commission of Sichuan Province [16PJ298]; Science and Technology Administration, Chengdu [2015-RK00-00233-ZF]
语种：
外文
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2017]版：
大类|2 区医学
小类|2 区肿瘤学3 区细胞生物学
最新[2023]版：
无
第一作者：
第一作者机构：[1]Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
共同第一作者：
通讯作者：
通讯机构：[1]Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
推荐引用方式(GB/T 7714)：
Chenjing Zhu,Jiaming Liu,Jing Zhang,et al.Efficacy and safety of dose-dense chemotherapy in urothelial carcinoma.[J].Oncotarget.2017,8(41):71117-71127.doi:10.18632/oncotarget.16759.
APA：
Chenjing Zhu,Jiaming Liu,Jing Zhang,Qingfang Li,Qisi Lian...&Xuelei Ma.(2017).Efficacy and safety of dose-dense chemotherapy in urothelial carcinoma..Oncotarget,8,(41)
MLA：
Chenjing Zhu,et al."Efficacy and safety of dose-dense chemotherapy in urothelial carcinoma.".Oncotarget 8..41(2017):71117-71127
