Preliminary Results of Neoadjuvant M-VAC(Methotrexate, Vinblastine, Adriamycin, Cisplatin) Chemotherapy for Bladder Carcinoma

Shin, Chul Soo; Ryu, Soo Bang

Abstract

The trend in chemotherapy of bladder carcinoma has evolved from the single agent to the combination chemotherapy. In 1985 Sternberg et al. reported 71 per cent of significant tumor regression and 50 per cent of complete clinical remission with M-VAC(methotrexate, vinblastine, adriamycin and cisplatin) combination chemotherapy of treatment for advanced urothelial transitional cell carcinomas. Therefore, the effects of neoadjuvant systemic M-VAC chemotherapy in 23 patients with bladder carcinoma at the Department of Urology, Chonnam University Hospital from January 1987 to June 1989 were evaluated. The following results were obtained. 1. The average number of cycle were 2.1 and the cycle length varied from 28 days to 52 days (average: 32.8 days). 2. Clinical complete and partial remission rate were obtained in 11 patients( 47.8 per cent), while 6 patients( 26.1 per cent) had a minor response, 4 patients( 17.4 per cent) stabilization and 2 patients (8.7 per cent) progression. 3. After chemotherapy, 13 patients underwent operation (radical cystectomy 8, partial cystectomy and lymph node dissection 4, transurethral resection of bladder tumor 1) and there were no lymphatic metastasis except only one advanced case. 4. Toxicity included leukopenia in 21 patients and all patients had experienced alopecia, nausea, vomiting and general weakness. It was suggested that neoadjuvant M-VAC chemotherapy may be effective as treatment for patients with invasive bladder carcinoma and we need to define further and extend the potential roles of neoadjuvant chemotherapy for carcinoma.