制癌剤注入療法抵抗性の再発性表在性膀胱腫瘍に対するBCG膀胱内注入療法

Abstract

Tokyo株BCG注入療法を制癌剤抵抗性の表在膀胱腫瘍8例に試みた.1)治療注入7例中3例にCRを得た.効果持続期間は平均11.7ヵ月であった.予防注入の1例は, 種々の前治療が無効であったがBCG注入療法開始後23ヵ月再発を認めていない.2)副作用は8例全例に膀胱刺激症状を, また膀胱全摘した2例の前立腺に組織学的に結核病変を認めた

Tokyo strain bacillus Calmette-Guerin (BCG) was instilled in a dose of 80 mg in 40 ml normal saline to the bladder of 8 patients with recurrent superficial bladder carcinoma (Ta, Tl, Tis) resistant to mitomycin C and/or adriamycin intravesical instillation chemotherapy. Instillation was performed weekly for 6 weeks and 3 to 4 weeks after the last instillation, the response was assessed by cystoscopy and urine cytology. Patients who achieved complete response underwent monthly maintenance instillation for a year and inspection with cystoscopy and urine cytology every 3 months. Of the 7 patients who underwent therapeutic instillation, 3 (43%) achieved complete response, and 2 partial response. Two patients with no response had carcinoma in situ of grade 3 anaplasia. Two of the 3 complete responders were free of disease for 11 and 12 months, but another 1 developed intravesical recurrence 13 months later. One patient underwent prophylactic instillation and remained free of disease for 23 months. Side effects included frequency, urgency and pain on urination which were tolerable with anti-analgesics. Two patients underwent total cystectomy because of tumor progression and had typical lesions of prostatic tuberculosis.