Combination chemotherapy of advanced bladder cancer

: Patients with carcinoma of the urinary bladder have a poor prognosis. When distant metastasis develops, such patients seldom survive for more than several months. For them, surgery and/or radiotherapy are of little value, and systemic chemotherapy has been thought to be the most useful treatment. Forty-six patients with advanced transitional cell carcinoma, including bladder cancer, (33 bladder, 9 ureter, 4 renal pelvis cases) were treated by a three drug combination chemotherapy, using two protocols (protocol I: adriamycin + cyclophosphamide + 5-fluorouracil, protocol II: adriamycin + cyclophosphamide + cis-platinum). Protocol I induced responses in 5 of the 24 patients (21%, 1 complete response, 4 partial responses), and protocol II in 7 of the 22 patients (32%, 1 complete response, 6 partial responses). The overall response rate was 26%. The durations of response (median duration 5.1 months) and of survival (median duration 11.3 months) in all responders were relatively short. The three-combination chemotherapy, especially protocol II, was effective against transitional cell carcinoma of the urinary tract, but the results were not satisfactory.