療指引 Men with high-volume, ADT-naïve, metastatic disease Docetaxel without prednisolone with ADT 藥品名劑量 /m 2 給藥日頻率參考文獻 Docetaxel 75 mg/m² 1 Q3W 1 藥品名劑量 /m 2 給藥日頻率參考文獻 Docetaxel 30-35 mg/m² 1 QW 3 泌尿道腫瘤抗癌藥物治Men with symptomatic mcrpc First-line Therapy Docetaxel with/without prednisolone Docetaxel 75 mg/m² Q3W 1 Prednisolone 5 mg Docetaxel 30-35 mg/m² QW 3 Prednisolone 5 mg 241
Alternative chemotherapy 療指引 Mitoxantrone with prednisolone Mitoxantrone 12 mg/m² 1 Q3W 2 Prednisolone 5 mg Cabazitaxel 25 1 Q3W 4 Prednisolone 10 mg 泌尿道腫瘤抗癌藥物治參考文獻 1. http://centerformenshealth.com/center-4-mens-health/new-treatment-now-available-that-extends-life-in-men-with-highlyadvanced-prostate-cancerthe study results of ECOG 3805 demonstrating OS benefit with early docetaxel chemotherapy may change standard of care in patients with extensive disease metastatic prostate cancer 2. Tannock IF, de Wit R, Berry WR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004;351:1502-1512. 3. Takahiro Kojima, Toru Shimazui, Mizuki Onozawa, Sadamu Tsukamoto, Shiro Hinotsu, et al. Weekly Administration of Docetaxel in Patients with Hormonerefractory Prostate Cancer: a Pilot Study on Japanese Patients 4. de Bono JS, Oudard S, Ozguroglu M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 2010;376:1147-1154. 242
泌尿道腫瘤抗癌藥物治療指引 Perioperative chemotherapy (neoadjuvant or adjuvant) Gemcitabine and cisplatin Gemcitabine 1,000 1, 8 Q3W 1.2 Cisplatin 70 1 Q3W Gemcitabine 1,000 1, 8 Q3W 1.2 Cisplatin 35 1, 8 Q3W Gemcitabine 1,000 1, 8 Q3W 1.2 Cisplatin 35 1, 2 Q3W Gemcitabine 1,000 1, 8, 15 Q4W 1.2 Cisplatin 70 1 Q4W CMV Methotrexate 30 1, 8 Q3W 3 Vinblastine 4 1, 8 Q3W Cisplatin 100 2 Q3W Folinic acid 15 mg 2, 9 Q3W 243
Adjuvant intravesical treatment 療指引 BCG 81 mg QW 4 QW for 3 weeks Mitomycin 20-40 mg QW 5-7 Intravesical MDP regimen Mitomycin 30 mg 1 Q3W 8-12 Doxorubicin 30 mg 8 Q3W Cisplatin 30 mg 15 Q3W Chemotherapy for Metastatic disease First-line Therapy Gemcitabine and cisplatin Gemctabine 800-1,000 mg/m 2 1, 8 Q3W 2.16 Cisplatin 50-70 mg/m 2 2 Q3W 244 泌尿道腫瘤抗癌藥物治
Gemcitabine and carboplatin 療指引 Gemctabine 800-1,000 mg/m 2 1, 8 Q3W 2.16 Carboplatin AUC=4-5 1 Q3W DDMVAC with growth factor support Methotrexate 30 mg/m 2 1 or 2 Q2W 17.18 Vinblastine 3 mg/m 2 1 or 2 Q2W Doxorubicin 20-30 mg/m 2 1 or 2 Q2W Cisplatin 50-70 mg/m 2 1 Q2W 泌尿道腫瘤抗癌藥物治 Methotrexate 30 mg/m 2 1 or 2 Q2W 17.18 Vinblastine 3 mg/m 2 1 or 2 Q2W Doxorubicin 20-30 mg/m 2 1 or 2 Q2W Carboplatin AUC=4-5 1 Q2W Radiosensitizing chemotherapy regimens for bladder-preserving chemoradiation following a maximal TURBT First-line Therapy Cisplatin 藥品名劑量 /m 2 給藥日頻率參考文獻 Cisplatin 30 mg/m 2 QW 19 245
Cisplatin and 5-FU 療指引 Cisplatin l 15 mg/m 2 1-3, 8-10, 15-17 10 5-FU 400 mg/m 2 1-3, 8-10, 15-17 5-FU and Mitomycin C Mitomycin C 12 mg/m 2 1 9 5-FU 500 mg/m 2 1-5, 16-20 Cisplatin and paclitaxel Cisplatin 15 mg/m 2 1-3, 8-10, 15-17 10 Paclitaxel 50 mg/m 2 1-3, 8-10, 15-17 Low-dose gemcitabin Gemcitabine 75 mg/m 2 QW 20 246 泌尿道腫瘤抗癌藥物治
療指引 參考文獻 1 Dash A, Pettus JA, Herr HW, et al. A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer 2008;113:2471-2477. 2 Von der Maase H, Hansen SW, Roberts JT, et al. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 2000;18:3068-3077. 3 Griffiths G, Hall R, Sylvester R, et al. International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol 2011;29:2171-2177. 4 Lamm DL1, Blumenstein BA, Crissman JD, et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol. 2000; 163: 1124-9 5 Lundholm C1, Norlén BJ, Ekman P, et al. A randomized prospective study comparing long-term intravesical instillations of mitomycin C and bacillus Calmette-Guerin in patients with superficial bladder carcinoma. J Urol. 1996; 156: 372-6 6 Solsona E, Iborra I, Ricos JV, et al: Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 1999; 161:1120-1123. 7 Witjes JA1, v d Meijden AP, Collette L, et al. Long-term follow-up of an EORTC randomized prospective trial comparing intravesical bacille Calmette-Guérin-RIVM and mitomycin C in superficial bladder cancer. EORTC GU Group and the Dutch South East Cooperative Urological Group. European Organisation for Research and Treatment of Cancer Genito-Urinary Tract Cancer Collaborative Group. Urology. 1998 ; 52: 403-10 8 Tunio MA, Hashmi A, Qayyum A, et al. Whole-pelvis or bladder-only chemoradiation for lymph node-negative invasive bladder cancer: single-institution experience. Int J Radiat Oncol Biol Phys. 2012; 82: e457-62 9 James ND, Hussain SA, Hall E, et al; BC2001 Investigators. Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 2012;366:1477-1488 10 Mitin T, Hunt D, Shipley W, et al. Transurethral surgery and twice-daily radiation plus paclitaxel-cisplatin or fluorouracilcisplatin with selective bladder preservation and adjuvant chemotherapy for patients with muscle invasive bladder cancer (RTOG 0233): a randomized multicentre phase 2 trial. Lancet Oncol 2013;14:863-872. 247 泌尿道腫瘤抗癌藥物治
11 Lamm DL1, Blumenstein BA, Crissman JD, et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, 療指引 T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol. 2000; 163: 1124-9 12 Lundholm C1, Norlén BJ, Ekman P, et al. A randomized prospective study comparing long-term intravesical instillations of mitomycin C and bacillus Calmette-Guerin in patients with superficial 13 Solsona E, Iborra I, Ricos JV, et al: Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 1999; 14 Witjes JA1, v d Meijden AP, Collette L, et al. Long-term follow-up of an EORTC randomized prospective trial comparing intravesical bacille Calmette-Guérin-RIVM and mitomycin C in 15 Chung-Hsin Chen, Hung-Ju Yang, Chia-Tung Shun, et al. A cocktail regimen of intravesical mitomycin-c, doxorubicin, and cisplatin (MDP) for non-muscle-invasive bladder cancer. 16 Von der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol 2005;23:4602-4608. 17 Sternberg CN, de Mulder PH, Schornagel JH, et al. Randomized phase III trial of high-dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European Organization for Research and Treatment of Cancer Protocol no. 30924. J Clin Oncol 2001;19:2638-2646. 18 Sternberg CN, de Mulder P, Schornagel JH, et al. Seven year update of an EORTC phase III trial of high-dose intensity M-VAC chemotherapy and G-CSF versus classic M-VAC in advanced urothelial tract tumours. Eur J Cancer 2006;42:50-54. 19 Jouhadi H, Sahraoui S, Benider A. Concurrent weekly cisplatin during radiation treatment of locally advanced bladder carcinoma in elderly patients. J Clin Oncol. 2008; 26(15) suppl. 20 Atasoy BM, Dane F, Alsan Cetin L, et al. Concurrent chemoradiotherapy with low dose weekly gemcitabine in medically inoperable muscle-invasive bladder cancer patients. Clin Transl Oncol. 2014; 16(1):91-95 248 泌尿道腫瘤抗癌藥物治