Key words Endostar advanced carcinoma of the renal pelvis partial remission

    0 Introduction

    Pelvis cancer is rare, accounting for 5% of malignant kidney tumor, pathological type is transitional cell carcinoma prone to distant metastases, and insensitive to most anticancer drugs, we Endostar combined GLX the treatment of advanced carcinoma of renal pelvis one cases of partial remission, the report is as follows.

    1 Materials and Methods

    Patient was a 44-year-old male. Left renal pelvic transitional cell carcinoma 2 years after I found multiple bone metastases, liver metastases six months hospitalized. Patients received treatment in a local hospital because of painless gross hematuria November 2004, CT and cystoscopy biopsy renal pelvis cancer associated with bladder implantation metastasis. In December of the same year, the left kidney resection, laparoscopic, left lower quadrant incision left ureter full cut, partial bladder resection. Pathological examination: “left kidney transitional cell carcinoma II level the BTCC II level, the left ureter and perirenal fat capsule no infringement. Postoperative multiple line the bladder infusion chemotherapy (doxorubicin, mitomycin, pyran factors, hydroxycamptothecin and epirubicin), white interleukin  2, interferon, and bladder cautery excision of the last treatment in June 2006. July 20, 2006 due to low back pain underwent MRI shows: the T12 the leading edge, see bone destruction. September 13, 2006, abdominal CT examination showed: about leaves multiple liver metastases (maximum diameter of the left lobe of the liver lesions about 2.5cm, the maximum diameter of the right lobe of the liver lesions were 3.2cm, 2.5cm and 1.0cm), local lumbar spine bone mineral destruction lesions infringement spinal. Due to the progress of the disease on September 21, 2006, October 12, 2006 the diverted Endostar Joint GLX program palliative two cycles of chemotherapy drugs: Endostar Injection (Endostar) 15mg VD d1 14 gemcitabine 1.2 g VD d1, 8, Xeloda 1.0g PO 2 / day D1 to 14, alkylene folate calcium 50 mg PO 2 / day D1 to 14. Went smoothly. November 8, 2006 to review the CT, RECIST evaluation criteria, measurable lesions compared with the previous reduced by about 40%, to evaluate the efficacy of a partial remission (PR). Figure 1. Continue the line of the original program four treatment cycles, the process is smooth. Again on July 10, 2007 CT scan evaluation efficacy maintain PR. Especially worth mentioning is that the quality of life of patients after treatment significantly improved compared with the previous unused analgesics state reached painless.

    September 13, 2006 pre-treatment CT

    CT image before and after treatment CT control after treatment on November 11, 2006

    2 Discussion

    Pelvis cancer is a malignant epithelial renal pelvic mucosa, early radical surgical resection can be used late chemoradiotherapy poor 5-year survival rate of only 4.3%. In recent years, anti-angiogenic drugs has become an important area of ​​research for the treatment of tumor invasion and metastasis. The growing body of data shows that the anti-angiogenic drug combination with chemotherapeutic drugs may improve efficacy, to bring a survival benefit. Endostar the (YH  16, Endostar) is a novel recombinant human endostatin, specific inhibition of endothelial cell proliferation and angiogenesis, thereby inhibiting tumor growth; tumor vascular endothelial cell proliferation and apoptosis restore to a state of equilibrium and non-cytotoxic, a broad spectrum of anti-tumor does not produce resistance [1  3]. Has been used to treat advanced non-small cell lung cancer (NSCLC) clinical Phase III clinical multi-center double-blind comparative study has indicated that Endostar with NP chemotherapy and have a synergistic effect, without increasing the NP adverse reaction [4].

    Gemcitabine deoxycytidine analogs, ribonucleotide reductase inhibitors, inside the cell by deoxycytidine kinase phosphorylation, transformed into the active diphosphate and nucleoside triphosphates, the anti tumor effects . For solid tumors, with a broad-spectrum anti-tumor effect. Casali M, et al [5] Gemcitabine (1 000mg/m2 IV d1, 8,15) the treatment of 16 patients evaluable for efficacy in patients with metastatic renal cell carcinoma, the total effective rate of 31%.

    RECIST evaluation criteria, efficacy for patients with advanced renal pelvis cancer Endostar combined GLX program after two treatment cycles, PR, and no significant adverse reactions, continue to repeat CT after 4 cycles of treatment remained PR, and the quality of life in patients with improved significantly.