[Urological cancer].

Gan To Kagaku Ryoho

Dept. of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Published: February 2009

Chemotherapy has a major role in the multidisciplinary treatment of urological cancer. Especially cisplatin-based combination chemotherapy plays a central role in the treatment of bladder cancer and testicular cancer. Intravesical chemotherapy for non-muscle-invasive bladder cancer has a clear impact on tumor recurrence when immediately instilled after TURBT and when used in an adjuvant setting. However, there is no clear evidence of an impact on progression. The consensus is that anticancer drugs should be used preferentially over BCG for low-risk disease. Systemic combination chemotherapy for muscle-invasive bladder cancer yields high response rates but suboptimal longterm outcomes for advanced bladder cancer. GC therapy provides similar efficacy in terms of overall survival and progression-free survival compared with M-VAC but with a superior safety profile. In the treatment of prostate cancer, docetaxel has become the treatment of choice for patients with hormone refractory cancer. A treatment strategy for testicular cancer has been established, and a high response rate is obtained even in advanced cancer. However, further innovations in treatment for patients with poor prognosis are required. Thus, new anticancer drugs such as taxanes and gemcitabine were added to cisplatin-based chemotherapy, and a treatment of urological cancer is progressing.

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