Abstract
Objective:
We report on central nervous system metastases from urothelial bladder carcinoma in patients treated with M-VAC chemotherapy.
Methods:
50 patients with advanced transitional cell carcinoma of the bladder were treated with the M-VAC regimen at the Hôpital Cochin (Paris, France) between December 1989 and February 1995. Brain relapses were diagnosed by CT scanning.
Results:
We observed a surprising increase in the number of central nervous system relapses (8/50) in patients treated consecutively at the same institution. The mean time to metastatic recurrence in the brain from the initiation of first chemotherapy was 21 months (range 7-38). Six patients had single and 2 patients had multiple central nervous system metastases. Treatment consisted of radiotherapy alone (n = 5) or both surgery and radiotherapy (n = 3). Median survival time from the appearance of cerebral metastases was 3 months (range 1-10).
Conclusion:
The prolonged duration of remissions which are achieved following M-VAC chemotherapy may explain the greater likelihood of the detection of cerebral involvement.
MeSH terms
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Aged
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Brain Neoplasms / diagnostic imaging
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Brain Neoplasms / epidemiology*
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Brain Neoplasms / secondary*
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Brain Neoplasms / therapy
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Carcinoma, Transitional Cell / diagnostic imaging
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Carcinoma, Transitional Cell / drug therapy*
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Carcinoma, Transitional Cell / mortality
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Carcinoma, Transitional Cell / secondary*
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Cisplatin / administration & dosage
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Cisplatin / pharmacology
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Doxorubicin / administration & dosage
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Doxorubicin / pharmacology
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Female
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Follow-Up Studies
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Humans
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Incidence
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Liver Neoplasms / secondary
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Lung Neoplasms / secondary
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Lymphatic Metastasis
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Male
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Methotrexate / administration & dosage
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Methotrexate / pharmacology
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Middle Aged
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Prognosis
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Radiography
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Retrospective Studies
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Severity of Illness Index
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Survival Rate
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Urinary Bladder Neoplasms / drug therapy*
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Urinary Bladder Neoplasms / mortality
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Urinary Bladder Neoplasms / pathology
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Vinblastine / administration & dosage
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Vinblastine / pharmacology
Substances
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Vinblastine
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Doxorubicin
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Cisplatin
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Methotrexate