Antiblastic chemotherapy of the urological tumors proves to be effective in germ-cell testicular tumor, in bladder cancer and in penis cancer, while a real effective anticancer therapy for prostatic and renal cell cancer has not found yet. There is not a significant difference between BVP and BEP regimens as first-line treatments of the good risk germ-cell testicular tumors. On the contrary BEP showed a lower toxicity and an higher efficacy in the treatment of the poor risk patients. Considering salvage therapies, PEI regimen proves to be as the most effective, also in the management of patients pretreated with BEP; high dose chemotherapy with autologous bone marrow transplant is currently examined as third-line therapy. In the treatment of bladder cancer the most effective drugs are Methotrexate, Adriamycine, Vinblastine and Cyclophosphamide, that, when combined, are sensitively more efficacious. The different chemotherapies achieved elevated percentage of Complete and Partial Responses (CR + PR): however these results are maintained in only 10% of the cases. So far the aim of the last studies is to improve the results both with a modification of posology and of the schedule of administration, and with the employ of growth-factors to reduce toxicity. An appreciable improvement in the treatment of locally advanced penis cancer has been achieved employing VBM regimen as adjuvant therapy, especially for patients with extrinsicated lymph-nodal metastases, who underwent bilateral inguinal and iliac lymphadenectomy. The same therapy did not produce analogous results when administered as neoadjuvant chemotherapy: combination of Cisplatin and 5-Fluorouracil shows higher efficacy both as neoadjuvant and as salvage therapy. The efficacy of Suramine in the treatment of the prostatic cancer is currently assessed. Nevertheless its employ is complicated by the close therapeutic margins and the elevated toxicity. Antiblastic chemotherapy has not to be currently considered as routinary treatment in the management of renal cell carcinoma.
|Translated title of the contribution||Chemotherapy of the urological metastases|
|Number of pages||7|
|Journal||Archivio italiano di urologia, nefrologia, andrologia : organo ufficiale dell"Associazione per la ricerca in urologia = Urological, nephrological, and andrological sciences|
|Publication status||Published - 1992|
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