浸潤性膀胱癌に対する動注化学療法

Abstract

動注化学療法は, 高齢・主要臓器機能低下等のlow risk症例においても諸家の報告と遜色のない効果が得られたことより, 今後更に検討に値する治療法の一つと考えられる.neoadjuvant療法としての有用性も期待できるが, 今後neoadjuvant療法の目的の一つであるmicrometastasisに対して全身化学療法を上回る有用性があるか否か等多くの課題も残されており, randomized studyによる多数症例での検討も必要と考える

The present investigation was conducted to examine the effects of intra-arterial chemotherapy (IAC) for patients with invasive bladder cancer. A total of 37 patients were treated with IAC at Nara Medical University and its affiliated hospitals between January, 1993 and August, 1997. There were 27 patients in the poor risk group. The remaining 10 patients underwent anti-tumor IAC. Thirty of the 37 patients received chemotherapeutic agents via a reservoir, and the remaining 7 patients received a one-shot injection of agents followed by transcatheter arterial embolization (TAE). In the reservoir group, there were 18 patients who received IAC in combination with radiation therapy. As a result, reduction of tumor size was noted in 53%, and the 3-year cause-specific survival rate was 54% in all cases. There was a significant difference in the 3-year survival rate between the radiation-treated group and the group without radiation. The adverse events included anemia, leukopenia, thrombocytopenia and gastrointestinal symptoms, but none of them were severe. The results of the present study indicate that IAC is useful in the treatment of invasive bladder cancer for poor risk patients.