浸潤性膀胱癌患者に対する膀胱温存を目的とした動注化学療法の検討

Abstract

CDDP+ADMの動注化学療法を行った浸潤性膀胱癌15例の成績を報告した.主要病変に対する効果は完全寛解が10例(66.7%), 部分寛解3例(20.0%), 変化なし1例(6.7%), 悪化が1例(6.7%)であった.追加療法として全身化学療法(MTX+ADM+VBL+CDDP)を行った1例では, 部分寛解から完全寛解になった.上皮内癌や多発性表在性膀胱癌を伴った2例はBacillus Calmette-Guerin膀胱内注入療法を追加することで2例とも完全寛解が得られた.動注化学療法の合併症として2例に下肢痛や下肢知覚異常, 坐骨神経障害, 排尿痛, 尿道狭窄などを認めたが, いずれも対症療法によって改善した

Intraarterial chemotherapy (IAC) was carried out on patients with invasive bladder carcinoma to treat the bladder carcinoma while preserving the bladder. Fifteen patients with bladder carcinoma at stage T2-T4 were treated with intraarterial cisplatin (CDDP: 70 mg/m2) and adriamycin (ADM: 30 mg/m2) every 3 to 4 weeks. The response was observed in all 15 patients. Ten (66.7%) achieved a complete response (CR), and 3 (20.0%) obtained a partial response (PR). With a mean follow-up of 22.6 months, the overall survival rate was 86.7% and 12 patients were alive with functioning bladder. One patient received radical cystectomy. Although further studies and long-term follow up are required to clarify its effectiveness, IAC for patients with invasive bladder carcinoma might be an effective therapy with a preserved bladder.