膀胱癌・前立腺癌に対するリザーバー動注化学療法の経験

Abstract

他臓器の合併症を初めとしてなんらかの理由で手術施行が不可能であった進行性膀胱癌15例, 膀胱全摘除術試行後の骨盤内再発10例に対しSeldinger法に準じて皮下埋没型リザーバーシステムを設置し動注化学療法を施行.局所再燃前立腺癌23例, 内分泌療法不応性局所進行型前立腺癌5例に対してリザーバーを動注化学療法を施行.使用薬剤は, methotrexate, cis-platinum, adriamycinを用いた動注化学療法を入院で施行, 外来通院中で可能な症例には5-FUもしくはcarboplatinを維持化学療法として施行.膀胱癌で平均6回, 前立腺癌で平均4回施行.局所が制癌されている期間には, 遠隔部位での増悪は認めなかった.膀胱癌でPR18例NC7例, 前立腺癌でPR11例, NC14例.奏効期間は, 膀胱癌で最大46ヵ月, 中央値23ヵ月, 前立腺癌で最大32ヵ月, 中央値12ヵ月.副作用は, 全身化学療法に比較して軽度であった

A clinical study was performed on the efficacy of intra-arterial chemotherapy using a reservoir system for advanced urological malignancies. The reservoir system was indwelted in the femoral subcutaneous layer by Seldinger's method. Fifteen cases of inoperable complicated advanced bladder cancer and 10 cases of postoperative local recurrent bladder cancer were administered intra-arterial chemotherapy using a reservoir system. Then, 23 cases of local relapsed prostate cancer and two cases of endpocrine-resistant prostate cancer were administered the chemotherapy. The administered anti-cancerous agents were methotraxate, cis-platinum and adriamycin, then 5-FU or carboplatin was administered as maintenance therapy. The mean number of courses of chemotherapy was six for bladder cancer and four for prostate cancer. During stabilization of the local lesion, no distant deterioration was recognized. The overall clinical efficacy was a positive response (PR) and no change (NC): for 18 and 7 cases of bladder cancer, and 11 and 14 cases of prostate cancer, respectively. The median duration of stabilization was 23 months for bladder cancer and 12 months for prostate cancer. The adverse effects were fever than those with systemic chemotherapy.